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Related Experiment Videos

Elevated nucleosome levels in systemic inflammation and sepsis.

Sacha Zeerleder1, Bas Zwart, Walter A Wuillemin

  • 1University Hospital, Bern, Switzerland.

Critical Care Medicine
|July 9, 2003
PubMed
Summary

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Elevated nucleosome levels indicate cell death in severe sepsis and septic shock. This suggests apoptosis may drive multiple organ dysfunction syndrome, a severe complication with high mortality.

Area of Science:

  • Cellular Biology
  • Immunology
  • Critical Care Medicine

Background:

  • Multiple organ dysfunction syndrome (MODS) is a common and fatal complication of severe sepsis and septic shock.
  • The cellular mechanisms underlying MODS remain incompletely understood.

Purpose of the Study:

  • To investigate the role of apoptosis in the pathogenesis of MODS.
  • To assess circulating nucleosome levels as markers of apoptosis in patients with sepsis.

Main Methods:

  • Retrospective study involving 69 patients with fever, systemic inflammatory response syndrome, severe sepsis, or septic shock.
  • Measured circulating nucleosome levels using enzyme-linked immunosorbent assay.
  • Assessed MODS severity using sepsis scores and clinical variables.

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Main Results:

  • Elevated nucleosome levels were detected in a high percentage of patients across the sepsis spectrum, increasing with disease severity.
  • Nucleosome levels were significantly higher in septic shock patients and non-survivors compared to others.
  • In advanced MODS, nucleosome levels correlated with cytokine levels and outcome predictors.

Conclusions:

  • Patients with severe sepsis and septic shock exhibit elevated plasma nucleosome levels.
  • Apoptosis, likely triggered by inflammatory mediators, is implicated in the pathogenesis of MODS.