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Monocyte CD14 changes and endotoxemia after major hepatectomy
S Komatsu1, Y Moriwaki, S Togo
1Second Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan.
Hepato-Gastroenterology
|January 30, 2002
Summary
Decreased membrane CD14 (mCD14) levels accurately diagnose endotoxemia, outperforming standard endotoxin tests. This finding suggests mCD14 monitoring is valuable for detecting endotoxemia, including endogenous cases post-hepatectomy.
Area of Science:
- Immunology
- Clinical Diagnostics
- Sepsis Research
Background:
- Endotoxemia, a condition involving endotoxins, is a serious clinical concern.
- Membrane CD14 (mCD14), the endotoxin receptor on monocytes, is a potential biomarker.
- The diagnostic utility of mCD14 in endotoxemia and post-hepatectomy settings requires clarification.
Purpose of the Study:
- To evaluate if reduced membrane CD14 (mCD14) levels indicate endotoxemia.
- To determine if endogenous endotoxemia occurs after hepatectomy.
- To compare the diagnostic accuracy of mCD14 with existing endotoxin detection methods.
Main Methods:
- Assessed serum endotoxin levels using the ES method.
- Measured mCD14 expression (positive rate and MFI-CD14) and soluble CD14 (sCD14).
- Analyzed mCD14-positive rates in 13 hepatectomy patients, correlating with infection markers.
Main Results:
- mCD14-positive rate showed the highest diagnostic accuracy (95.5%) for endotoxemia.
- ES method, MFI-CD14, and sCD14 had accuracies of 77.3%, 86.7%, and 66.7%, respectively.
- Reduced mCD14 rates in hepatectomy patients correlated with infections, including suspected endogenous endotoxemia in one case.
Conclusions:
- Decreased mCD14-positive rate is a highly accurate diagnostic marker for endotoxemia.
- mCD14 monitoring offers a superior diagnostic approach compared to the ES method.
- Endogenous endotoxemia was suspected in 8% of patients following extended hepatectomy based on mCD14 reduction.