title: Change of hemopexin level is associated with the severity of sepsis in endotoxemic rat model and the outcome of septic patients.
abstract: OBJECTIVE
  The purpose of the study is to uncover the role of hemopexin (HPX) as anti-inflammatory mediator in animals and humans.
  
  
  METHODS
  We injected rats with 5 and 10 mg/kg of lipopolysaccharide to induce low- and high-grade endotoxemia (LGE and HGE), respectively, and we measured serum levels of tumor necrosis factor α, interleukin 6, and HPX at 0, 1, 3, and 6 hours after the injection. In a clinical study, we measured the initial serum HPX concentrations of septic shock patients. We evaluated the correlation between HPX levels and sepsis severity in rats and the predictive value of the HPX level for 28-day mortality of patients.
  
  
  RESULTS
  In rats, serum interleukin 6 and tumor necrosis factor α concentrations were lower in LGE than in HGE, whereas the HPX level in HGE at 6 hours was significantly lower than in LGE (0.88, interquartile range [0.79-1.00] vs 1.33, interquartile range [1.29-1.49] mg/mL, P= .002). In patients, the initial serum HPX level in nonsurvivors was significantly lower than in survivors (0.75 vs 1.02 mg/mL, P< .001). Multivariate logistic regression analysis revealed that HPX exhibited independent prognostic value for 28-day mortality, and its levels were closely related to Acute Physiology and Chronic Health Evaluation II scores.
  
  
  CONCLUSIONS
  Low serum HPX levels are related to sepsis severity and could indicate poor prognosis for septic shock patients.
authors.affiliation: Department of Emergency Medicine, Seoul National University School of Medicine, Seoul, Republic of Korea. Electronic address: matewoos@gmail.com.
authors.forename: Jae Yun
authors.initials: JY
authors.lastname: Jung
authors.affiliation: Department of Emergency Medicine, Seoul National University School of Medicine, Seoul, Republic of Korea. Electronic address: yhkwak@snuh.org.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kwak
authors.affiliation: Department of Emergency Medicine, Seoul National University School of Medicine, Seoul, Republic of Korea. Electronic address: kanesu@gmail.com.
authors.forename: Kyung Su
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University School of Medicine, Seoul, Republic of Korea. Electronic address: kwy711@hanmail.net.
authors.forename: Woon Yong
authors.initials: WY
authors.lastname: Kwon
authors.affiliation: Department of Emergency Medicine, Seoul National University School of Medicine, Seoul, Republic of Korea. Electronic address: suhgil@snu.ac.kr.
authors.forename: Gil Joon
authors.initials: GJ
authors.lastname: Suh
mesh_terms: D000818:Animals; D016208:Databases, Factual; D004195:Disease Models, Animal; D018450:Disease Progression; D019446:Endotoxemia / Q000139:chemically induced / Q000378:metabolism*; D005260:Female; D006466:Hemopexin / Q000378:metabolism*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008070:Lipopolysaccharides / Q000633:toxicity; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D051381:Rats; D018805:Sepsis / Q000378:metabolism / Q000401:mortality; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000378:metabolism* / Q000401:mortality; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015850:Interleukin-6; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; C433788:lipopolysaccharide, E. coli O26-B6; D006466:Hemopexin
keywords: Endotoxemia; Hemopexin; Human; Inflammation; Sepsis