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Plasma gelsolin depletion and circulating actin in sepsis: a pilot study
Po-Shun Lee1, Sanjay R Patel, David C Christiani
1Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, MA, USA. plee4@partners.org
Plos One
|November 13, 2008
Summary
Low plasma gelsolin (pGSN) levels in sepsis patients correlate with mortality. Circulating actin is a marker of sepsis, and pGSN depletion is linked to poor outcomes.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Immunology
Background:
- Plasma gelsolin (pGSN) depletion observed in sepsis patients.
- Hypothesis: pGSN reduction correlates with sepsis outcomes and circulating actin indicates sepsis.
Purpose of the Study:
- To investigate the correlation between pGSN levels and sepsis patient outcomes.
- To determine if circulating actin is a manifestation of sepsis.
Main Methods:
- Assayed pGSN in plasma from 21 non-surgical septic ICU patients.
- Detected circulating actin (actinemia) in sepsis patients.
Main Results:
- Actinemia detected in 17/21 septic patients.
- Survivors had significantly higher pGSN levels (163 mg/L) than non-survivors (89 mg/L).
- pGSN levels predicted 28-day mortality more strongly than APACHE III scores; each quartile reduction increased mortality odds 3.4-fold.
Conclusions:
- Circulating actin and pGSN deficiency are associated with early sepsis.
- The extent of pGSN deficiency correlates with sepsis mortality.
- Reversing pGSN deficiency may offer an effective sepsis treatment strategy.
