title: Plasma HSPA12B is a potential predictor for poor outcome in severe sepsis.
abstract: BACKGROUND
  Endothelium-derived molecules may be predictive to organ injury. Heat shock protein (HSP) A12B is mainly located in endothelial cells, which can be detected in the plasma of septic patients. Whether it is correlated with prognosis of sepsis remains unclear.
  
  
  METHODS
  Extracellular HSPA12B (eHSPA12B) was determined in plasma of septic mice at 6 h, 12 h, 24 h and 48 h after cecal ligation and puncture (CLP). It was also detected in plasma of patients with severe sepsis, sepsis, systemic inflammatory response syndrome and healthy volunteers. The predictive value for prognosis of severe sepsis was assessed by receiver operating curve (ROC) and Cox regression analyses.
  
  
  RESULTS
  eHSPA12B was elevated in plasma of CLP mice at 6 h and peaked at 24 h after surgery. A total of 118 subjects were included in the clinical section, including 66 patients with severe sepsis, 21 patients with sepsis, 16 patients with SIRS and 15 volunteers. Plasma eHSPA12B was significantly higher in patients with severe sepsis than in patients with sepsis, SIRS and volunteers. The level of eHSPA12B was also higher in non-survivals than survivals with severe sepsis. The area under the curve (AUC) of eHSPA12B in predicting death among patients with severe sepsis was 0.782 (0.654-0.909) in ROC analysis, much higher than that of IL-6 and IL-10. Cox regression analysis showed that cardiovascular diseases, IL-6 and eHSPA12B were risk factors for mortality in patients with severe sepsis. Survival curve demonstrated a strikingly significant difference between 28-day survival rates of patients with an eHSPA12B lower or not lower than 1.466 ng/ml.
  
  
  CONCLUSIONS
  Plasma eHSPA12B is elevated in both septic mice and patients. It may be a good predictor for poor outcome in patients with severe sepsis.
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Ran
authors: R
authors: Zhang
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Xiao-jian
authors: XJ
authors: Wan
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Xu
authors: X
authors: Zhang
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Qiu-xiang
authors: QX
authors: Kang
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Jin-jun
authors: JJ
authors: Bian
authors: Department of Anesthesiology, the Third People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors: Gui-fang
authors: GF
authors: Yu
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Jia-feng
authors: JF
authors: Wang
authors: Department of Anesthesiology and Intensive Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
authors: Ke-ming
authors: KM
authors: Zhu
mesh_terms: D000328:Adult; D000818:Animals; D002432:Cecum / Q000473:pathology; D003710:Demography; D005110:Extracellular Space / Q000378:metabolism; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008026:Ligation; D008297:Male; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D011379:Prognosis; D011677:Punctures; D012372:ROC Curve; D018805:Sepsis / Q000097:blood*; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018840:HSP70 Heat-Shock Proteins; C472131:HSPA12B protein, human; C513783:HSPA12B protein, mouse; D015850:Interleukin-6; D016753:Interleukin-10