title: Trefoil factor 2 expression and its significance as a predictor of severity of sepsis in children.
abstract: Intestinal injury significantly contributes to critical illness, sepsis and multiorgan failure. TFF2 (Trefoil Factor 2) is expressed and secreted preferentially by gastric mucous neck cells. TFF2 gene expression is promptly increased after gut injury, and its expression profile broadens to include the regenerative epithelia of virtually the entire gastrointestinal tract. The first objective of our study was an analysis of TFF2 levels dynamics in patients with Systemic Inflammatory Response Syndrome (SIRS) or septic condition during a 5-day period after admission. The second objective was to determine optimal cut-off value and quantify diagnostic characteristics of TFF2 between controls and patients with various septic states. The study included 57 children aged 0-19 years, with expected or proven SIRS and septic condition. The degree of severity was evaluated according to PELOD Score (Pediatric Logistic Organ Dysfunction). Blood samples to determine levels of TFF2 factor were taken during the time patient met the criteria of SIRS or sepsis. Control group samples to determine the serum levels of TFF2 were taken from patients undergoing elective surgery. Analysis of TFF2 levels dynamics revealed that TFF2 levels kept steady state during the 5-day period. Significantly higher levels of TFF2 were in patients with Multiple Organ Dysfunction Syndrome (MODS). The difference was noticed also in ROC analysis.
authors.affiliation: Department of Anesthesia and Intensive Care, University Children's Hospital, Černopolní 9, Brno 62500, Czech Republic. jzurek@fnbrno.cz
authors.forename: Jiří
authors.initials: J
authors.lastname: Zurek
authors.forename: Michal
authors.initials: M
authors.lastname: Kýr
authors.forename: Martin
authors.initials: M
authors.lastname: Vavřina
authors.forename: Michal
authors.initials: M
authors.lastname: Fedora
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005753:Gastric Mucosa / Q000166:cytology / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000293:injuries; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood / Q000378:metabolism; D010455:Peptides / Q000097:blood* / Q000378:metabolism*; D012372:ROC Curve; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000378:metabolism* / Q000601:surgery; D000071164:Trefoil Factor-2
chemical_list: D010455:Peptides; C000604007:TFF2 protein, human; D000071164:Trefoil Factor-2
keywords: ANOVA; AUC; CLP; Children; EGF; Epidermal Growth Factor; FABP; Fatty Acid Binding Proteins; Gut; HRP; MODS; Mortality; Multiple Organ Dysfunction Syndrome; PELOD; Paediatric Logistic Organ Dysfunction; ROC; SE; SIRS; SP; Sepsis; TFF2; Trefoil Factor 2; Trefoil factor; analysis of variance; area under the curve; cecal ligation and puncture; horseradish peroxidase; receiver operating characteristic; sensitivity; specifity; systemic inflammatory response syndrome