Elevated growth-arrest-specific protein 6 plasma levels in patients with severe sepsis.
OBJECTIVE
Growth-arrest-specific protein 6 (Gas6), an intracellular protein released by apoptotic cells, has been detected in normal plasma. As the Gas6 system has been implicated in mouse susceptibility to sepsis, and as leukocyte apoptosis is thought to play a major role in the physiopathology of human severe sepsis, we studied Gas6 plasma levels and possibly related variables in patients with severe sepsis.


METHODS
Matched case-control study.


METHODS
Adult intensive care unit in a university hospital.


METHODS
Thirty patients with severe sepsis, 30 patients with organ failure not related to infection, and 30 healthy subjects matched for age and gender.


METHODS
Blood draw.


RESULTS
Gas6 plasma levels were quantified using enzyme-linked immunosorbent assay. Whole-blood gas6 messenger RNA levels were measured by quantitative real-time polymerase chain reaction. Gas6 plasma levels were elevated (110 ng/mL [75, 139]; median values [interquartile range]) in severe sepsis patients compared with organ failure patients (85 ng/mL [56, 101]) and healthy subjects (54 ng/mL [49, 68]). In patients with severe sepsis, this increase correlated with the Acute Physiology and Chronic Health Evaluation II severity score, the organ failure Organ Dysfunction and Infection (ODIN) score, and the existence of a septic shock. Gas6 messenger RNA levels were increased in patients with severe sepsis and correlated specifically with the monocyte count.


CONCLUSIONS
In severe sepsis, the recently described anti-apoptotic protein Gas6 was found at high levels in plasma and correlated well with the degree of organ dysfunction.
Borgel
Delphine
D
Inserm U428, Service d'Hématologie Biologique A, Hôpital Européen Georges Pompidou, Paris, France. delphine.borgel@univ-paris5.fr
Clauser
Sylvain
S
Bornstain
Caroline
C
Bièche
Ivan
I
Bissery
Alvine
A
Remones
Véronique
V
Fagon
Jean-Yves
JY
Aiach
Martine
M
Diehl
Jean-Luc
JL
D018806:APACHE; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D018450:Disease Progression; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D000099255:Growth Arrest-Specific Protein 6
D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; D000099255:Growth Arrest-Specific Protein 6