title: Circulating glycosaminoglycan species in septic shock.
abstract: BACKGROUND
  Glycosaminoglycans (GAGs) are negatively charged polysaccharides present, e.g., on the luminal face of the blood vessels as heparan sulphate (HS) and hyaluronic acid (HA), in the interstitium as HA, and in neutrofils and plasma as chondroitin sulphate (CS) and HA. Total plasma levels of GAG are increased in human septic shock, but the origin and pathophysiological implications are unclear. In order to determine the source of circulating GAG in sepsis, we compared plasma levels of HS, HA, CS and keratan sulphate (KS) in patients with septic shock and controls.
  
  
  METHODS
  HS and KS were measured with enzyme-linked immunosorbent assay, and HA and CS disaccharides with liquid chromatography tandem mass spectrometry in plasma obtained from patients admitted to intensive care fulfilling criteria for septic shock as well as from matched control patients scheduled for neurosurgery.
  
  
  RESULTS
  Median levels of HS and HA were fourfold increased in septic shock and were higher in patients that did not survive 90 days (threefold and fivefold for HS and HA, respectively). Median CS levels were unaltered, while KS levels were slightly decreased in sepsis patients. HS and HA levels correlated with levels of interleukin-6 and interleukin-10. Except for HA, GAG levels did not correlate to liver or kidney sequential organ function score.
  
  
  CONCLUSIONS
  Median plasma level of HS and HA is increased in septic shock patients, are higher in patients that do not survive, and correlates with inflammatory activation and failing circulation. The increased levels could be due to vascular damage.
authors.affiliation: Section of Anesthesiology and Intensive Care, Department of Clinical Sciences, Lund University and Skane University Hospital, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Nelson
authors.forename: I
authors.initials: I
authors.lastname: Berkestedt
authors.forename: M
authors.initials: M
authors.lastname: Bodelsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002809:Chondroitin Sulfates / Q000378:metabolism; D004187:Disaccharides / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006025:Glycosaminoglycans / Q000097:blood*; D006497:Heparan Sulfate / Q000097:blood; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007202:Indicators and Reagents; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007632:Keratan Sulfate / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000175:diagnosis; D009195:Peroxidase / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000382:microbiology; D012772:Shock, Septic / Q000097:blood*; D013534:Survival
chemical_list: D002097:C-Reactive Protein; D002809:Chondroitin Sulfates; D004187:Disaccharides; D006025:Glycosaminoglycans; D006497:Heparan Sulfate; D006820:Hyaluronic Acid; D007202:Indicators and Reagents; D016753:Interleukin-10; D015850:Interleukin-6; D007632:Keratan Sulfate; D009195:Peroxidase