title: Elevated plasmatic level of soluble IL-7 receptor is associated with increased mortality in septic shock patients.
abstract: OBJECTIVE
  Adjunctive immunoadjuvant therapies are now proposed in the treatment of septic patients that develop immune dysfunctions. However, a prerequisite is to identify patients at high risk of death that would benefit from such therapy. Knowing that rhIL-7 is a putative candidate for septic shock treatment, we evaluated the association between increased plasmatic level of soluble CD127 (sCD127, IL-7 receptor alpha chain) and mortality after septic shock.
  
  
  METHODS
  sCD127 plasmatic level was measured in 70 septic shock patients sampled at day 1-2 (D1) and day 3-4 (D3) after the onset of shock and 41 healthy volunteers.
  
  
  RESULTS
  Compared with survivors, non-survivors presented with significantly higher sCD127 concentrations at D1 and D3 (p < 0.001 and p = 0.002). At D1, the area under the receiver operating characteristic curve for sCD127 level association with mortality was 0.846 (p < 0.0001). Kaplan-Meier survival curves illustrated that mortality was significantly different after stratification based on D1 sCD127 level (log rank test, hazard ratio 9.10, p < 0.0001). This association was preserved in multivariate logistic regression analysis including clinical confounders (age, SAPS II and SOFA scores, odds ratio 12.71, p = 0.003). Importantly, patient stratification on both D1 sCD127 value and SAPS II score improved this predictive capacity (log rank test, p = 0.0001).
  
  
  CONCLUSIONS
  Increased sCD127 plasmatic level enables the identification of a group of septic shock patients at high risk of death. After confirmation in a larger cohort, this biomarker may be of interest for patient stratification in future clinical trials.
authors: Cellular Immunology Laboratory, Hôpital E. Herriot, Hospices Civils de Lyon, Pavillon E, 5 place d'Arsonval, 69437, Lyon Cedex 03, France.
authors: Julie
authors: J
authors: Demaret
authors: Astrid
authors: A
authors: Villars-Méchin
authors: Alain
authors: A
authors: Lepape
authors: Jonathan
authors: J
authors: Plassais
authors: Hélène
authors: H
authors: Vallin
authors: Christophe
authors: C
authors: Malcus
authors: Françoise
authors: F
authors: Poitevin-Later
authors: Guillaume
authors: G
authors: Monneret
authors: Fabienne
authors: F
authors: Venet
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D053699:Interleukin-7 Receptor alpha Subunit / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012772:Shock, Septic / Q000097:blood / Q000401:mortality*
chemical_list: D015415:Biomarkers; D053699:Interleukin-7 Receptor alpha Subunit