Plasma biomarkers in carbon monoxide poisoning

Objectives. The severity of acute carbon monoxide (CO) poisoning is often based on non-specific clinical criteria because there are no reliable laboratory markers. We hypothesized that a pattern of plasma protein values might objectively discern CO poisoning severity. This was a pilot study to evalu...

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Bibliographic Details
Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2010-01, Vol.48 (1), p.47-56
Main Authors: Thom, Stephen R., Bhopale, Veena M., Milovanova, Tatyana M., Hardy, Kevin R., Logue, Christopher J., Lambert, David S., Troxel, Andrea B., Ballard, Kerri, Eisinger, Dominic
Format: Article
Language:English
Subjects:
Adult
Autoantibodies - blood
Biomarkers
Blood Proteins - analysis
Carbon Monoxide Poisoning - blood
Carbon Monoxide Poisoning - therapy
Carboxyhemoglobin - analysis
Chemokines - blood
Cytokines
Cytokines - blood
Female
Hormones - blood
Humans
Hyperbaric oxygen
Inflammatory markers
Intercellular Signaling Peptides and Proteins - blood
Interleukins - blood
Male
Middle Aged
Neurotoxicity Syndromes - physiopathology
Pilot Projects
Smoke inhalation
Smoke Inhalation Injury - physiopathology
Treatment Outcome
Young Adult
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Summary:Objectives. The severity of acute carbon monoxide (CO) poisoning is often based on non-specific clinical criteria because there are no reliable laboratory markers. We hypothesized that a pattern of plasma protein values might objectively discern CO poisoning severity. This was a pilot study to evaluate protein profiles in plasma samples collected from patients at the time of initial hospital evaluation. The goal was to assess whether any values differed from age- and sex-matched controls using a commercially available plasma screening package. Methods. Frozen samples from 63 suspected CO poisoning patients categorized based on clinical signs, symptoms, and blood carboxyhemoglobin level were analyzed along with 42 age- and sex-matched controls using Luminex-based technology to determine the concentration of 180 proteins. Results. Significant differences from control values were found for 99 proteins in at least one of five CO poisoning groups. A complex pattern of elevations in acute phase reactants and proteins associated with inflammatory responses including chemokines cytokines and interleukins, growth factors, hormones, and an array of auto-antibodies was found. Fourteen protein values were significantly different from control in all CO groups, including patients with nominal carboxyhemoglobin elevations and relatively brief intervals of exposure. Conclusions. The data demonstrate the complexity of CO pathophysiology and support a view that exposure causes acute inflammatory events in humans. This pilot study has insufficient power to discern reliable differences among patients who develop neurological sequelae but future trials are warranted to determine whether plasma profiles predict mortality and morbidity risks of CO poisoning.
ISSN:1556-3650
1556-9519
DOI:10.3109/15563650903468209