title: Plasma levels of chemokine ligand 20 and chemokine receptor 6 in patients with sepsis: A case control study.
abstract: BACKGROUND
  Chemokine ligand 20 (CCL20) is a chemokine released by mainly liver and blood leucocytes. Particularly under pro-inflammatory circumstances it triggers chemotaxis of lymphocytes and dendritic cells via activating receptor chemokine receptor 6 (CCR6) that is specific to it. In experimental sepsis models, the chemokine-receptor pair has been identified as a potential pathophysiological axis affecting mortality.
  
  
  OBJECTIVE
  Measurement of CCL20 and CCR6 plasma levels in septic patients compared with postsurgical, nonseptic patients.
  
  
  METHODS
  Case control study.
  
  
  METHODS
  Surgical ICUs of the Department of Anaesthesiology, General Hospital of Vienna, Vienna, Austria.
  
  
  METHODS
  Plasma levels were measured in 46 patients with sepsis, severe sepsis or septic shock according to current American College of Chest Physicians/Society of Critical Care Medicine criteria at the day of sepsis onset. Plasma levels in 36 postsurgical controls without sepsis admitted to the ICU were investigated. Plasma concentrations were determined by using commercially available ELISA kits. Data are given as median and interquartile range (IQR).
  
  
  METHODS
  CCL20 and CCR6 plasma levels.
  
  
  RESULTS
  CCL20 plasma levels were significantly increased in the sepsis group: 220.9 pg ml (IQR, 72.8 to 540.1) compared with the ICU controls: 37.0 pg ml (IQR 6.5 to 83.6) (P < 0.0001). Significantly elevated CCR6 levels were found in the sepsis group: 2.47 ng ml (IQR 0.92 to 5.54) compared with the controls: 0.59 ng ml (IQR 0.17 to 1.48) (P < 0.0001). Both CCL20 and CCR6 correlated with the maximum sequential organ failure assessment score (CCL20: P < 0.0001, CCR6: P < 0.0001). Length of ICU admission depended significantly on the logarithm of CCR6 (P = 0.008) and sequential organ failure assessment maximum (P < 0.0001).
  
  
  CONCLUSIONS
  There were early increased plasma concentrations of CCL20 and CCR6 in patients with sepsis. CCL20 and CCR6 correlate with severity of illness in ICU patients. Levels of CCR6 predicted the length of patients' admission.
authors.affiliation: From the Department of Anaesthesiology, General Intensive Care and Pain Medicine (DAK, MCM, BT, DLE, MW, CGK, GAR); RAIC Laboratory 13C1 (DAK, MCM, BT, DLE, MW, CGK, GAR); Department of Craniomaxillofacial and Oral Surgery (RS); Comparative Medicine Unit, Messerli Research Institute, University of Veterinary Medicine Vienna, and University of Vienna (FRW); and Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (EE).
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Klaus
authors.forename: Rudolf
authors.initials: R
authors.lastname: Seemann
authors.forename: Franziska
authors.initials: F
authors.lastname: Roth-Walter
authors.forename: Elisa
authors.initials: E
authors.lastname: Einwallner
authors.forename: Michael C
authors.initials: MC
authors.lastname: Motal
authors.forename: Bianca
authors.initials: B
authors.lastname: Tudor
authors.forename: Diana
authors.initials: D
authors.lastname: Lebherz-Eichinger
authors.forename: Marion
authors.initials: M
authors.lastname: Wiegele
authors.forename: Claus G
authors.initials: CG
authors.lastname: Krenn
authors.forename: Georg A
authors.initials: GA
authors.lastname: Roth
mesh_terms: D000368:Aged; D001317:Austria; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D054418:Chemokine CCL20 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006769:Hospitals, General; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D011379:Prognosis; D054399:Receptors, CCR6 / Q000097:blood*; D012307:Risk Factors; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C108355:CCL20 protein, human; C106311:CCR6 protein, human; D054418:Chemokine CCL20; D018836:Inflammation Mediators; D054399:Receptors, CCR6