title: PROGNOSTIC VALUE OF PLASMA TIGHT-JUNCTION PROTEINS FOR SEPSIS IN EMERGENCY DEPARTMENT: AN OBSERVATIONAL STUDY.
abstract: BACKGROUND
  Studies have illustrated that the breakdown of tight junction (TJ) contributed to an increase in vascular permeability in response to stimulation of inflammatory cytokines. Additionally, the release of TJ-associated proteins into the circulation was observed in many diseases. The present study was designed to investigate whether plasma levels of TJ-associated proteins could serve as predictors of severity and clinical outcome of sepsis.
  
  
  METHODS
  In total, 51 septic patients were enrolled. The peripheral blood samples were collected for each patient on emergency department arrival. Plasma levels of occludin (OCLN), claudins (CLDN)-5, and zonula occludens (ZO)-1 and serum levels of procalcitonin (PCT) and lactate were measured. In addition, APACHE II score as well as SOFA score was calculated. The prognostic values of OCLN, CLDN-5, and ZO-1 were compared with the first 24-h maximum APACHE II score and SOFA score.
  
  
  RESULTS
  The median levels of OCLN and ZO-1 were elevated with sepsis severity. The levels of plasma OCLN and ZO-1 were positively correlated with APACHE II score, SOFA score as well as lactate levels of the patients. The levels of ZO-1 revealed valuable diagnostic capacity to diagnose MODS, and the areas under the receiver-operating characteristic (AUC) curves of ZO-1 were similar to those of lactate levels, but better than those of PCT levels. The prognostic value for in-hospital mortality of ZO-1 was comparable to that of lactate levels, APACHE II score, and SOFA score, and superior to OCLN or PCT.
  
  
  CONCLUSIONS
  OCLN and ZO1 levels appear to be early prognostic markers in patients suffering from sepsis.
authors: *Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou †Trauma Research Center, First Hospital Affiliated the Chinese PLA General Hospital, Beijing, P.R. China.
authors: Guang-Ju
authors: GJ
authors: Zhao
authors: Dong
authors: D
authors: Li
authors: Qian
authors: Q
authors: Zhao
authors: Jie
authors: J
authors: Lian
authors: Tian-Tian
authors: TT
authors: Hu
authors: Guang-Liang
authors: GL
authors: Hong
authors: Yong-Ming
authors: YM
authors: Yao
authors: Zhong-Qiu
authors: ZQ
authors: Lu
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D062507:Claudin-5 / Q000097:blood; D018572:Disease-Free Survival; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062793:Occludin / Q000097:blood*; D011379:Prognosis; D018805:Sepsis / Q000097:blood / Q000401:mortality; D015996:Survival Rate; D019108:Tight Junctions / Q000378:metabolism*; D062826:Zonula Occludens-1 Protein / Q000097:blood*
chemical_list: D015415:Biomarkers; C107466:CLDN5 protein, human; D062507:Claudin-5; C568985:OCLN protein, human; D062793:Occludin; C569042:TJP1 protein, human; D062826:Zonula Occludens-1 Protein