Growth arrest-specific protein 6 plasma concentrations during septic shock.
BACKGROUND
The product of growth arrest-specific gene 6 (Gas6) is a vitamin K dependent protein that is secreted by leucocytes and endothelial cells in response to injury and participates in cell survival, proliferation, migration and adhesion. Our purpose was to investigate plasma Gas6 concentration and its relation to organ dysfunction in patients with septic shock.


METHODS
Forty-five patients with septic shock admitted to a medical adult intensive care unit were enrolled. Plasma Gas6 concentration was determined using enzyme-linked immunosorbent assay at days 1, 3, 7 and 14.


RESULTS
The median (interquartile range) Gas6 concentration was 51 (5 to 95) pg/ml at admission. A positive correlation (Spearman rank-order coefficient [rs] = 0.37, P = 0.01) was found between Gas6 level and Sepsis-related Organ Failure Assessment score. Patients requiring renal support had higher Gas6 concentration that those without need for haemofiltration (76.5 [52 to 164] pg/ml versus 10.5 [1.5 to 80.5] pg/ml; P = 0.04). Moreover, there was a positive correlation between Gas6 and aspartate transaminase (rs = 0.42, P = 0.006) and between Gas6 and prothrombin time (rs = 0.45, P = 0.02). Although there was a progressive decline in Gas6 concentration in survivors (analysis of variance, P = 0.01), nonsurvivors exhibited persistently elevated Gas6. However, the two populations diverged only after day 7 (P = 0.04).


CONCLUSIONS
Plasma concentrations of Gas6 correlate with disease severity, especially with renal and hepatic dysfunction, in septic shock.
Gibot
Sébastien
S
Service de Réanimation Médicale, Avenue du Maréchal de Lattre de Tassigny, Hôpital Central, Nancy, France. s.gibot@chu-nancy.fr
Massin
Frédéric
F
Cravoisy
Aurélie
A
Dupays
Rachel
R
Barraud
Damien
D
Nace
Lionel
L
Bollaert
Pierre-Edouard
PE
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology; D008107:Liver Diseases / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000150:complications / Q000401:mortality; D000099255:Growth Arrest-Specific Protein 6
D001219:Aspartate Aminotransferases; D036341:Intercellular Signaling Peptides and Proteins; D000099255:Growth Arrest-Specific Protein 6