title: Plasma gelsolin depletion and circulating actin in sepsis: a pilot study.
abstract: BACKGROUND
  Depletion of the circulating actin-binding protein, plasma gelsolin (pGSN) has been described in septic patients and animals. We hypothesized that the extent of pGSN reduction correlates with outcomes of septic patients and that circulating actin is a manifestation of sepsis.
  
  
  RESULTS
  We assayed pGSN in plasma samples from non-surgical septic patients identified from a pre-existing database which prospectively enrolled patients admitted to adult intensive care units at an academic hospital. We identified 21 non-surgical septic patients for the study. Actinemia was detected in 17 of the 21 patients, suggesting actin released into circulation from injured tissues is a manifestation of sepsis. Furthermore, we documented the depletion of pGSN in human clinical sepsis, and that the survivors had significantly higher pGSN levels than the non-survivors (163+/-47 mg/L vs. 89+/-48 mg/L, p = 0.01). pGSN levels were more strongly predictive of 28-day mortality than APACHE III scores. For every quartile reduction in pGSN, the odds of death increased 3.4-fold.
  
  
  CONCLUSIONS
  We conclude that circulating actin and pGSN deficiency are associated with early sepsis. The degree of pGSN deficiency correlates with sepsis mortality. Reversing pGSN deficiency may be an effective treatment for sepsis.
authors.affiliation: Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, MA, USA. plee4@partners.org
authors.forename: Po-Shun
authors.initials: PS
authors.lastname: Lee
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Patel
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Ednan
authors.initials: E
authors.lastname: Bajwa
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Stossel
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Waxman
mesh_terms: D018806:APACHE; D000199:Actins / Q000097:blood*; D018260:Gelsolin / Q000097:blood*; D006801:Humans; D010865:Pilot Projects; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000401:mortality; D015996:Survival Rate
chemical_list: D000199:Actins; D018260:Gelsolin