Antagonistic sepsis markers: Serum gelsolin and actin/gelsolin ratio.
OBJECTIVE
For appropriate sepsis care, prognostic laboratory markers are mandatory. The aim of our study was to evaluate the predictive value of serum actin, gelsolin and the recently defined actin/gelsolin ratio during sepsis by comparison it to classical clinical and inflammatory laboratory parameters.


METHODS
We analyzed sera of severe septic (n=32) and SIRS (n=12) patients for 5days. Ophthalmologic patients (n=27) served as controls. Besides serum actin, gelsolin and actin/gelsolin ratios classical laboratory parameters (WBC count, serum procalcitonin, hsCRP) and clinical scores (APACHE II, SAPS II, SOFA), were also assessed.


RESULTS
Septic patients showed significantly decreased first-day gelsolin levels and increased actin/gelsolin ratios compared to SIRS patients (p<0.05), furthermore, non-survivors had significantly lower gelsolin levels compared to survivors (p<0.05). Non-survivors had 11.4-fold higher 2nd day actin/gelsolin ratios than survivors. Besides procalcitonin (PCT) and hsCRP, gelsolin and actin/gelsolin ratios also proved to be useful in discriminating SIRS from sepsis in the ICU (p<0.05). Gelsolin had similar prognostic value to PCT when assessing 7-day mortality and the predictive capacity of the first-day actin/gelsolin ratios was similar to that of APACHE II score regarding ICU mortality in severe sepsis.


CONCLUSIONS
Serum gelsolin and actin/gelsolin ratio might serve as efficient complementary prognostic markers in sepsis. However, for daily clinical usage, an automated laboratory assay of actin and gelsolin is still needed to be developed.
Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary.
Zoltán
Z
Horváth-Szalai
Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Department of Anaesthesiology and Intensive Therapy, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary.
Péter
P
Kustán
Department of Anaesthesiology and Intensive Therapy, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary.
Diána
D
Mühl
Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary.
Andrea
A
Ludány
Department of Biophysics, University of Pécs, 7624 Pécs, Szigeti út 12, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary.
Beáta
B
Bugyi
Department of Laboratory Medicine, University of Pécs, 7624 Pécs, Ifjúság u. 13, Hungary; Szentágothai Research Center, 7624 Pécs, Ifjúság u. 20, Hungary. Electronic address: tamas.koszegi@aok.pte.hu.
Tamás
T
Kőszegi
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000199:Actins / Q000097:blood*; D000368:Aged; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000097:blood; D005260:Female; D018260:Gelsolin / Q000097:blood*; D005978:Glutathione / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000473:pathology; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D018805:Sepsis / Q000097:blood*
D000199:Actins; D018260:Gelsolin; D006710:Homocysteine; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine; D005978:Glutathione
Actin; Gelsolin; Predictive value; Scavenger protein; Sepsis; Systemic inflammation