New immunological serum markers in bacteraemia: anti-inflammatory soluble CD163, but not proinflammatory high mobility group-box 1 protein, is related to prognosis.
High mobility group-box 1 protein (HMGB1) is a late-onset proinflammatory cytokine. Soluble haemoglobin scavenger receptor (sCD163) is a specific marker of anti-inflammatory macrophages. The study purpose was to relate the levels of these new markers in bactaeremic patients to levels of well-known pro- and anti-inflammatory markers [procalcitonin, lipopolysaccharide (LPS)-binding protein, interleukin (IL)-6, IL-10] and to evaluate the levels in relation to disease severity and aetiology. A total of 110 patients with bacteraemia were included in a prospective manner from the medical department at a large Danish university hospital. Levels of HMGB1 and sCD163 were higher in patients with bacteraemia compared to controls (P < 0.001). HMGB1 correlated with proinflammatory molecules [procalcitonin (PCT)] and traditional infectious parameters [C-reactive proteins (CRP), white blood cells (WBC) and neutrophils], whereas sCD163 correlated with levels of IL-6, IL-10 but not to lipopolysaccharide-binding protein (LBP), PCT or CRP. Levels of sCD163 and IL-6 were significantly higher among non-survivors compared to survivors (P < 0.05). Neither HMGB1 nor any of the proinflammatory markers were elevated in fatal cases compared to survivors. There was no statistically significant difference in HMGB1 and sCD163 levels in Gram-negative versus Gram-positive bacteraemia. HMGB1 reflects proinflammatory processes, whereas sCD163 reflects anti-inflammatory processes as judged by correlations with traditional marker molecules. sCD163 and IL-6, but not HMGB1, were prognostic markers in this cohort pointing to an anti-inflammatory predominance in patients with fatal disease outcome.
Gaïni
S
S
Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. shahin.gaini@ouh.fyns-amt.dk
Pedersen
S S
SS
Koldkaer
O G
OG
Pedersen
C
C
Moestrup
S K
SK
Møller
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood*; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood*; D016470:Bacteremia / Q000175:diagnosis / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000276:immunology; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies; D011956:Receptors, Cell Surface / Q000097:blood*; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000276:immunology; D016019:Survival Analysis; D000098902:CD163 Antigen
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D000098902:CD163 Antigen; D024243:HMGB1 Protein; D018836:Inflammation Mediators; D011956:Receptors, Cell Surface