title: Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis.
abstract: 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.
authors.affiliation: Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yaegashi
authors.forename: Kamon
authors.initials: K
authors.lastname: Shirakawa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Sato
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kojika
authors.forename: Satoko
authors.initials: S
authors.lastname: Imai
authors.forename: Gaku
authors.initials: G
authors.lastname: Takahashi
authors.forename: Michiko
authors.initials: M
authors.lastname: Miyata
authors.forename: Shoji
authors.initials: S
authors.lastname: Furusako
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Endo
mesh_terms: 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
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors