Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis.
CD14, a high-affinity receptor for lipopolysaccharide (LPS), is a glycoprotein expressed on the surface membranes of monocytes/macrophages. We have identified a previously unknown form of soluble CD14, named soluble CD14 subtype (sCD14-ST), that is increased in patients with sepsis. To measure sCD14-ST concentrations in plasma, we prepared anti-sCD14-ST antibodies and developed an enzyme immunoassay (EIA) for this soluble form of CD14. With this assay, quantitative measurements are available within 4 h, and we compared the levels of sCD14-ST in plasma from normal subjects (healthy controls), patients with systemic inflammatory response syndrome (SIRS), and sepsis patients. The level of sCD14-ST in subjects with sepsis was much higher than the levels in subjects with SIRS and the healthy controls. Additionally, when a subject's sCD14-ST level was used as a diagnostic marker for sepsis, the area under the receiver operating characteristic (ROC) curve was 0.817, thereby demonstrating that elevated sCD14-ST levels were a better marker for sepsis than the other molecular markers we tested. sCD14-ST levels also correlated with procalcitonin (PCT) levels and with sequential organ failure assessment (SOFA) scores. Finally, changes in sCD14-ST concentration correlated with the severity of sepsis. Taken together, these results indicate that sCD14-ST is a useful marker for the rapid diagnosis of sepsis and for monitoring the severity of the disease.
Yaegashi
Yasunori
Y
Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
Shirakawa
Kamon
K
Sato
Nobuhiro
N
Suzuki
Yasushi
Y
Kojika
Masahiro
M
Imai
Satoko
S
Takahashi
Gaku
G
Miyata
Michiko
M
Furusako
Shoji
S
Endo
Shigeatsu
S
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D012372:ROC Curve; D018805:Sepsis / Q000175:diagnosis*; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis
D015415:Biomarkers; D018950:Lipopolysaccharide Receptors