PROGNOSTIC VALUE OF PLASMA TIGHT-JUNCTION PROTEINS FOR SEPSIS IN EMERGENCY DEPARTMENT: AN OBSERVATIONAL STUDY

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...

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Published in:Shock (Augusta, Ga.) Ga.), 2016-03, Vol.45 (3), p.326-332
Main Authors: Zhao, Guang-Ju, Li, Dong, Zhao, Qian, Lian, Jie, Hu, Tian-Tian, Hong, Guang-liang, Yao, Yong-Ming, Lu, Zhong-Qiu
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - blood
Claudin-5 - blood
Disease-Free Survival
Emergency Service, Hospital
Female
Hospital Mortality
Humans
Male
Middle Aged
Occludin - blood
Prognosis
Sepsis - blood
Sepsis - mortality
Survival Rate
Tight Junctions - metabolism
Zonula Occludens-1 Protein - blood
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Summary: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. CONCULSIONS:OCLN and ZO1 levels appear to be early prognostic markers in patients suffering from sepsis.
ISSN:1073-2322
1540-0514
DOI:10.1097/SHK.0000000000000524