title: Procollagen type III aminoterminal propeptide as biomarker of host response in severe sepsis.
abstract: OBJECTIVE
  The purpose of this study is to test the hypothesis that procollagen type III aminoterminal propeptide (PIIINP) is early elevated in septic episodes and can indicate the acute organ dysfunction/failure characterizing severe sepsis.
  
  
  METHODS
  This prospective study included 107 consecutive septic patients (44 with sepsis, 13 with severe sepsis, and 50 with septic shock) and 45 controls. After blood sampling (within 48 hours after onset of septic episodes), serum was assayed. Patients were followed up, and their disease severity was daily evaluated.
  
  
  RESULTS
  Procollagen type III aminoterminal propeptide (median [range]) increased in patients with sepsis (9.4 [2.2-42.4] ng/mL) compared with controls (3.6 [1.9-4.9] ng/mL; P<.001), exhibiting further significant increase in patients with severe sepsis and septic shock (19.5 [6.0-52.4] and 20.2 [1.8-89.2] ng/mL, respectively; P<.01-.001 vs sepsis). Among biomarkers of host response severity, PIIINP was the sole that was independently associated with severe sepsis/septic shock (P=.01). The area under the receiver operating characteristic curve for PIIINP to predict which patients with sepsis would eventually develop severe sepsis/septic shock was 0.87; the cutoff of 12 ng/mL had sensitivity 82% and specificity 89%.
  
  
  CONCLUSIONS
  Increased serum PIIINP can signify severe sepsis/septic shock and predict which patients with sepsis will eventually develop severe sepsis/septic shock, thus representing a biomarker of risk stratification of patients with sepsis.
authors.affiliation: First Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evaggelismos Hospital, GR-10675, Athens, Greece. Electronic address: szakynthinos@yahoo.com.
authors.forename: Spyros
authors.initials: S
authors.lastname: Zakynthinos
authors.forename: Spyros
authors.initials: S
authors.lastname: Papanikolaou
authors.forename: Spyros
authors.initials: S
authors.lastname: Mentzelopoulos
authors.forename: Evangellia
authors.initials: E
authors.lastname: Konstandelou
authors.forename: Christina
authors.initials: C
authors.lastname: Psachoulia
authors.forename: Antonis
authors.initials: A
authors.lastname: Mavrommatis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide
keywords: Biomarkers; Host response; Sepsis; Septic shock; Severe sepsis