scholarly journals Elevated Omentin Serum Levels Predict Long-Term Survival in Critically Ill Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Mark Luedde ◽  
Fabian Benz ◽  
Jennifer Niedeggen ◽  
Mihael Vucur ◽  
Hans-Joerg Hippe ◽  
...  
Keyword(s):  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Serum Levels ◽  
Healthy Controls ◽  
Serum Concentrations ◽  
Term Survival ◽  
Icu Patients ◽  
Icu Treatment

Introduction. Omentin, a recently described adipokine, was shown to be involved in the pathophysiology of inflammatory and infectious diseases. However, its role in critical illness and sepsis is currently unknown. Materials and Methods. Omentin serum concentrations were measured in 117 ICU-patients (84 with septic and 33 with nonseptic disease etiology) admitted to the medical ICU. Results were compared with 50 healthy controls. Results. Omentin serum levels of critically ill patients at admission to the ICU or after 72 hours of ICU treatment were similar compared to healthy controls. Moreover, circulating omentin levels were independent of sepsis and etiology of critical illness. Notably, serum concentrations of omentin could not be linked to concentrations of inflammatory cytokines or routinely used sepsis markers. While serum levels of omentin were not predictive for short term survival during ICU treatment, low omentin concentrations were an independent predictor of patients’ overall survival. Omentin levels strongly correlated with that of other adipokines (e.g., leptin receptor or adiponectin), which have also been identified as prognostic markers in critical illness. Conclusions. Although circulating omentin levels did not differ between ICU-patients and controls, elevated omentin levels were predictive for an impaired patients’ long term survival.

scholarly journals Regulation and Prognostic Relevance of Symmetric Dimethylarginine Serum Concentrations in Critical Illness and Sepsis

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Alexander Koch ◽  
Ralf Weiskirchen ◽  
Jan Bruensing ◽  
Hanna Dückers ◽  
Lukas Buendgens ◽  
...  
Keyword(s):  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiorgan Failure ◽  
Microvascular Dysfunction ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Symmetric Dimethylarginine ◽  
Term Survival ◽  
Severity Scores

In systemic inflammation and sepsis, endothelial activation and microvascular dysfunction are characteristic features that promote multiorgan failure. As symmetric dimethylarginine (SDMA) impacts vascular tension and integrity via modulating nitric oxide (NO) pathways, we investigated circulating SDMA in critical illness and sepsis. 247 critically ill patients (160 with sepsis, 87 without sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU) and on day 7, in comparison to 84 healthy controls. SDMA serum levels were significantly elevated in critically ill patients at admission to ICU compared to controls and remained stably elevated during the first week of ICU treatment. The highest SDMA levels were found in patients with sepsis. SDMA levels closely correlated with disease severity scores, biomarkers of inflammation, and organ failure (renal, hepatic, and circulatory). We identified SDMA serum concentrations at admission as an independent prognostic biomarker in critically ill patients not only for short-term mortality at the ICU but also for unfavourable long-term survival. Thus, the significant increase of circulating SDMA in critically ill patients indicates a potential pathogenic involvement in endothelial dysfunction during sepsis and may be useful for mortality risk stratification at the ICU.

scholarly journals Low Myostatin Serum Levels Are Associated with Poor Outcome in Critically Ill Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 574
Author(s):  
Theresa H. Wirtz ◽  
Sven H. Loosen ◽  
Lukas Buendgens ◽  
Berkan Kurt ◽  
Samira Abu Jhaisha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
Muscle Growth ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Icu Patients ◽  
Cox Regression Analysis ◽  
Independent Prognostic Marker ◽  
Unfavorable Clinical Outcome

Background: Growth differentiation factor 8, GDF-8 (Myostatin), is a protein released by myocytes inhibiting muscle growth and differentiation. Serum concentrations of Myostatin can predict poor survival in different chronic diseases, but its role in critical illness and sepsis is obscure. Our aim was to investigate Myostatin levels as a potential prognostic biomarker in critically ill patients with sepsis. Methods: We therefore measured Myostatin serum concentrations in 165 critically ill patients (106 with sepsis, 59 without sepsis) upon admission to the medical intensive care unit (ICU), in comparison to 14 healthy controls. Results: Myostatin levels were significantly decreased in ICU patients compared to controls but did not differ in patients with or without sepsis. However, Myostatin concentrations were significantly lower in patients requiring mechanical ventilation and indicated a trend towards dependency of intravenous vasopressors. Interestingly, we observed a negative correlation between Myostatin levels and markers of systemic inflammation. Strikingly, overall survival (OS) was significantly impaired in patients with low Myostatin levels in all critically ill patients. Low Myostatin levels at baseline turned out as an independent prognostic marker for OS in multivariate Cox-regression analysis (HR: 0.433, 95% CI: 0.211–0.889, p = 0.023). Conclusions: In summary, serum Myostatin concentrations are significantly decreased in critically ill patients and associated with disease severity. Low Myostatin levels also identify a subgroup of ICU patients that are more likely to face an unfavorable clinical outcome in terms of OS.

scholarly journals miR-155 Predicts Long-Term Mortality in Critically Ill Patients Younger than 65 Years

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Frank Tacke ◽  
Martina E. Spehlmann ◽  
Mihael Vucur ◽  
Fabian Benz ◽  
Mark Luedde ◽  
...  
Keyword(s):  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prognostic Biomarker ◽  
Serum Levels ◽  
Disease Etiology ◽  
Age Related ◽  
Age Dependent ◽  
Similar Accuracy

Introduction. Alterations in miR-155 serum levels have been described in inflammatory and infectious diseases. Moreover, a role for miR-155 in aging and age-related diseases was recently suggested. We therefore analyzed a potential age-dependent prognostic value of circulating miR-155 as a serum-based marker in critical illness. Methods. Concentrations of circulating miR-155 were determined in 218 critically ill patients and 76 healthy controls. Results. By using qPCR, we demonstrate that miR-155 serum levels are elevated in patients with critical illness when compared to controls. Notably, levels of circulating miR-155 were independent on the severity of disease, the disease etiology, or the presence of sepsis. In the total cohort, miR-155 was not an indicator for patient survival. Intriguingly, when patients were subdivided according to their age upon admission to the ICU into those younger than 65 years, lower levels of miR-155 turned out as a strong marker, indicating patient mortality with a similar accuracy than other markers frequently used to evaluate critically ill patients on a medical ICU. Conclusion. In summary, the data provided within this study suggest an age-specific role of miR-155 as a prognostic biomarker in patients younger than 65 years. Our study is the first to describe an age-dependent miRNA-based prognostic biomarker in human diseases.

scholarly journals Elevated Serum Levels of Mixed Lineage Kinase Domain-Like Protein Predict Survival of Patients during Intensive Care Unit Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mihael Vucur ◽  
Christoph Roderburg ◽  
Lukas Kaiser ◽  
Anne Theres Schneider ◽  
Sanchari Roy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cell Death ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill Patients ◽  
Serum Levels ◽  
Kinase Domain ◽  
Healthy Controls ◽  
Mixed Lineage Kinase ◽  
Icu Treatment

Mixed lineage kinase domain-like (MLKL), a crucial regulator of necroptotic cell death, was shown to play a role in inflammatory diseases. However, its role as a biomarker in critical illness and sepsis is currently unknown. We analyzed serum levels of MLKL in 136 critically ill patients at admission to the intensive care unit (ICU) and after three days of ICU treatment. Results were compared with 36 healthy controls and correlated with clinical and laboratory patients’ data. MLKL serum levels of critically ill patients at admission to the ICU were similar compared to healthy controls. At ICU admission, MLKL serum concentrations were independent of disease severity, presence of sepsis, and etiology of critical illness. In contrast, median serum levels of MLKL after three days of ICU treatment were significantly lower compared to those at admission to the ICU. While serum levels of MLKL at admission were not predictive for short-term survival during ICU treatment, elevated MLKL concentrations at day three were an independent negative predictor of patients’ ICU survival. Thus, elevated MLKL levels after three days of ICU treatment were predictive for patients’ mortality, indicating that sustained deregulated cell death is associated with an adverse prognosis in critical illness.

scholarly journals High Circulating Caspase-Cleaved Keratin 18 Fragments (M30) Indicate Short-Term Mortality in Critically Ill Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Alexander Koch ◽  
Eray Yagmur ◽  
Janine Linka ◽  
Fabienne Schumacher ◽  
Jan Bruensing ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Cell Injury ◽  
Serum Levels ◽  
Intermediate Filament Protein ◽  
Healthy Controls ◽  
Short Term ◽  
Icu Patients ◽  
Short Term Mortality ◽  
Keratin 18

Caspase-cleaved fragments of the intermediate filament protein keratin 18 (cytokeratin-18 (CK18)) can be detected in serum as M30 levels and may serve as a circulating biomarker indicating apoptosis of epithelial and parenchymal cells. In order to evaluate M30 as a biomarker in critical illness, we analyzed circulating M30 levels in 243 critically ill patients (156 with sepsis, 87 without sepsis) at admission to the medical intensive care unit (ICU), in comparison to healthy controls (n=32). M30 levels were significantly elevated in ICU patients compared with healthy controls. Circulating M30 was closely associated with disease severity but did not differ between patients with sepsis and ICU patients without sepsis. M30 serum levels were correlated with biomarkers of inflammation, cell injury, renal failure, and liver failure in critically ill patients. Patients that died at the ICU showed increased M30 levels at admission, compared with surviving patients. A similar trend was observed for the overall survival. Regression analyses confirmed that M30 levels are associated with mortality, and patients with M30 levels above 250.8 U/L displayed an excessive short-term mortality. Thus, our data support the utility of circulating levels of the apoptosis-related keratin fragment M30 as a prognostic biomarker at ICU admission.

scholarly journals Circulating MicroRNA-223 Serum Levels Do Not Predict Sepsis or Survival in Patients with Critical Illness

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Fabian Benz ◽  
Frank Tacke ◽  
Mark Luedde ◽  
Christian Trautwein ◽  
Tom Luedde ◽  
...  
Keyword(s):  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Inflammatory Responses ◽  
Elevated Serum ◽  
Serum Levels ◽  
Apache Ii Score ◽  
Circulating Microrna ◽  
Icu Patients ◽  
Markers Of Inflammation

Background and Aims. Dysregulation of miR-223 was recently linked to various diseases associated with systemic inflammatory responses such as type 2 diabetes, cancer, and bacterial infections. However, contradictory results are available on potential alterations of miR-223 serum levels during sepsis. We thus aimed to evaluate the diagnostic and prognostic value of miR-223 serum concentrations in patients with critical illness and sepsis.Methods. We used i.v. injection of lipopolysaccharide (LPS) as well as cecal pole ligation and puncture (CLP) for induction of polymicrobial sepsis in mice and measured alterations in serum levels of miR-223. These results from mice were translated into a large and well-characterized cohort of critically ill patients admitted to the medical intensive care unit (ICU). Finally, results from analysis in patients were correlated with clinical data and extensive sets of routine and experimental biomarkers.Results. Although LPS injection induced moderately elevated serum miR-223 levels in mice, no significant alterations in miR-223 serum levels were found in mice after CLP-induced sepsis. In accordance with these results from animal models, serum miR-223 levels did not differ between critically ill patients and healthy controls. However, ICU patients with more severe disease (APACHE-II score) showed moderately reduced circulating miR-223. Strikingly, no differences in miR-223 levels were found in critically ill patients with or without sepsis, and serum levels of miR-223 did not correlate with classical markers of inflammation or bacterial infection. Finally, low miR-223 serum levels were moderately associated with an unfavorable prognosis of patients during the ICU treatment but did not predict long-term mortality.Conclusion. Recent reports on alterations in miR-223 serum levels during sepsis revealed contradictory results, preventing a potential use of this miRNA in clinical routine. We clearly show that miR-223 serum levels do not reflect the presence of sepsis neither in mouse models nor in a large cohort of ICU patients and do not indicate clinical outcome of critically ill patients. Thus miR-223 serum levels should not be used as a biomarker in this setting.

scholarly journals Midregional Proadrenomedullin (MRproADM) Serum Levels in Critically Ill Patients Are Associated with Short-Term and Overall Mortality during a Two-Year Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Lukas Buendgens ◽  
Eray Yagmur ◽  
Axel Ginsberg ◽  
Ralf Weiskirchen ◽  
Theresa Wirtz ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Prognostic Biomarker ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Healthy Controls ◽  
Icu Mortality ◽  
Term Survival ◽  
Overall Mortality

Adrenomedullin (ADM) is a peptide with pleiotropic effects in systemic inflammation. Its more stable precursor protein midregional proadrenomedullin (MRproADM) can be measured more reliably compared to ADM. Our objective was to investigate the potential role of MRproADM as a diagnostic and prognostic biomarker in critically ill patients at the intensive care unit (ICU). We therefore measured MRproADM in 203 ICU patients and 66 healthy controls. We found that MRproADM levels are significantly increased in critically ill patients as compared to healthy controls. MRproADM levels are significantly increased in patients with sepsis, but its diagnostic value for identifying sepsis is numerically lower than that of established markers (e.g., interleukin-6, C-reactive protein, and procalcitonin). MRproADM levels are closely correlated to endothelial and organ dysfunction, inflammation, and established clinical scores (APACHE II, SOFA, and SAPS2). MRproADM concentrations correlate with vasopressor use but not fluid balance. Increased MRproADM levels (cut−off>1.4 nmol/L) in critically ill patients are independent predictors of ICU and overall mortality during a follow-up of up to 26 months (OR 3.15 for ICU mortality, 95% CI 1.08-9.20, p=0.036; OR for overall mortality 2.4, 95% CI 1.12-5.34, p=0.026). Our study demonstrates the potential of MRproADM serum levels as a prognostic biomarker in critical illness for ICU mortality and long-term survival during follow-up.

scholarly journals Elevated serum levels of bone sialoprotein during ICU treatment predict long-term mortality in critically ill patients

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Mark Luedde ◽  
Sanchari Roy ◽  
Hans-Joerg Hippe ◽  
David Vargas Cardenas ◽  
Martina Spehlmann ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Elevated Serum ◽  
Serum Levels ◽  
Bone Sialoprotein ◽  
Icu Treatment ◽  
Long Term Mortality

scholarly journals Serum Levels of miR-143 Predict Survival in Critically Ill Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Christoph Roderburg ◽  
Alexander Koch ◽  
Fabian Benz ◽  
Mihael Vucur ◽  
Martina Spehlmann ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Significance ◽  
Serum Levels ◽  
Icu Patients ◽  
Disease Etiology ◽  
Short And Long Term ◽  
Long Term Prognosis ◽  
Clinical Records

Background and Aims. Recent data suggested a potential role of miR-143 as a biomarker for systemic inflammation and infection. However, its role in critical illness and sepsis is only poorly understood. Methods. We determined circulating levels of miR-143 in 218 critically ill patients, of which 135 fulfilled sepsis criteria, and compared them to 76 healthy controls. Results were correlated with clinical records. Results. In the total cohort of critically ill patients from a medical intensive care unit (ICU), miR-143 serum levels tended to be lower compared to healthy control samples, but this difference did not reach statistical significance. In ICU patients, serum levels of miR-143 were independent of disease etiology, including the presence of sepsis, or severity of disease. Importantly, low miR-143 serum levels were associated with an unfavorable short- and long-term prognosis in ICU patients. Our study identified different optimal cut-off values at which low miR-143 serum levels predicted mortality with a high diagnostic accuracy. In line with this, concentrations of circulating miR-143 correlated with markers of organ failure such as creatinine, bilirubin, or lactate in our cohort of critically ill patients. Conclusion. Low miR-143 serum levels are indicative for an unfavorable short- and long-term prognosis in critically ill patients admitted to a medical ICU. Our data suggest a previously unrecognized role for miR-143 measurements as a novel prognostic marker in critically ill patients.

Protein C levels can be forecasted by global haemostatic tests in critically ill patients and predict long-term survival

2005 ◽  
Vol 116 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Gunnar Nilsson ◽  
Jan Astermark ◽  
Stefan Lethagen ◽  
Einar Vernersson ◽  
Erik Berntorp
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Protein C ◽  
Term Survival ◽  
Long Term Survival
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