Secretory non-pancreatic phopholipase A2 in severe sepsis: relation to endotoxin, cytokines and thromboxane B2.
Circulatory secretory non-pancreatic phospholipase A2 (snp-PLA2) was measured prospectively at the onset (day 0) of severe sepsis in 52 patients as well as on day 1 and 2 in 25 patients, in order to answer two questions: 1) does the snp-PLA2 plasma concentration differ according to the type and severity of infection? 2) what is the relation between snp-PLA2 and other mediators involved in severe sepsis, such as endotoxin, cytokines (TNF alpha, IL-1 beta, IL-6) and thromboxane B2 (the stable metabolite of thromboxane A2)? On day 0, the snp-PLA2 circulatory level was 78 +/- 17 nmol/min/ml in patients with severe sepsis as compared to 3.5 +/- 2 nmol/min/ml in 40 healthy volunteers. There was no statistical difference according to the outcome, the presence of shock, or the type of infection on day 0. However, snp-PLA2 remained elevated or even increased in patients who ultimately died, while it decreased in survivors (p = 0.01 by ANOVA). The cytokine profiles during the 2-day follow-up were similar to that of snp-PLA2, but the differences were not statistically significant between survivors and non-survivors. No correlation was found between snp-PLA2 and other mediators for either initial or peak values.
Guidet
B
B
Intensive Care Unit, URA CNRS 1283, Paris, France.
Piot
O
O
Masliah
J
J
Barakett
V
V
Maury
E
E
Bereziat
G
G
Offenstadt
G
G
D000328:Adult; D000368:Aged; D004731:Endotoxins / Q000032:analysis* / Q000097:blood; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000378:metabolism; D016908:Gram-Positive Bacterial Infections / Q000378:metabolism; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis* / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D010741:Phospholipases A / Q000032:analysis* / Q000097:blood; D054467:Phospholipases A2; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology / Q000378:metabolism* / Q000401:mortality; D012720:Severity of Illness Index; D013928:Thromboxane A2 / Q000032:analysis* / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D004731:Endotoxins; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D013928:Thromboxane A2; D010741:Phospholipases A; D054467:Phospholipases A2