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Published on: September 15, 2017
Soluble endothelial protein C receptor level in children with sepsis
Tanil Kendirli1, Erdal Ince, Ergin Ciftci
1Pediatric Intensive Care Unit, Ankara University School of Medicine, Ankara, Turkey. tanilkendirli@hotmail.com
Insights
Serum soluble endothelial protein C receptor (sEPCR) levels were not elevated in septic children. sEPCR did not prove to be a reliable prognostic marker for sepsis outcomes in this pediatric intensive care unit study.
Area of Science:
- Biochemistry
- Immunology
- Pediatrics
Background:
- Endothelial protein C receptor (EPCR) plays a key role in regulating blood coagulation and inflammation.
- EPCR enhances protein C activation, suggesting physiological significance in host defense against sepsis.
- Soluble EPCR (sEPCR) levels may reflect systemic EPCR activity.
Purpose of the Study:
- To evaluate serum-soluble EPCR (sEPCR) levels in children with sepsis.
- To determine if sEPCR levels correlate with sepsis severity or patient outcomes.
- To assess the prognostic value of sEPCR in pediatric sepsis.
Main Methods:
- A case-control study involving 39 septic children and 40 healthy controls in a pediatric intensive care unit.
- Serum sEPCR levels were measured using enzyme-linked immunosorbent assay (ELISA).
- Demographic data, clinical diagnoses (sepsis, septic shock, MODS, DIC), and mortality rates were recorded.
Main Results:
- Serum sEPCR levels were similar between septic children (87 ng/mL) and healthy controls (72 ng/mL) (p > .05).
- sEPCR levels did not differ significantly between survivors (96 ng/mL) and non-survivors (82.5 ng/mL) (p > .05).
- The most common pathogens were Escherichia coli and Klebsiella pneumonia, with a 25.6% mortality rate.
Conclusions:
- Serum sEPCR levels are not elevated in children diagnosed with sepsis.
- sEPCR is not a useful prognostic indicator for sepsis in the pediatric population.
- Further research may explore other biomarkers for predicting pediatric sepsis outcomes.
Abstract:
Endothelial protein C receptor (EPCR) is primarily localized on the endothelial cells of large blood vessels. EPCR enhances activation of protein C by 5- to 20-fold. EPCR appears to be physiologically significant in the control of blood coagulation and inflammation and in the host response to gram-negative sepsis. In this study, the authors evaluated serum-soluble EPCR level in septic children in a pediatric intensive care unit (PICU) in a university hospital. The study was performed between March 2006 and September 2007 and consisted of 39 patients with sepsis and 40 healthy children. Septic patients were enrolled consecutively. Serum-soluble EPCR level was determined by enzyme-linked immunosorbent assay. The ages of the children with sepsis and those in the control groups ranged between 59 +/- 68 and 68 +/- 52 months, respectively. The serum sEPCR levels of septic children and those in control groups were 87 (38-260) and 72 (42-180) ng/mL (p > .05), respectively. The mortality rate was 25.6% in our patients. Escherichia coli and Klebsiella pneumonia were the most common pathogens. Among these children 16 had sepsis, 23 had septic shock, 15 had multiple organ dysfuntion syndrome, and 12 had disseminated intravascular coagulation. sEPCR levels of survivors were 96 (44-260) and those of nonsurvivors' were 82.5 (38-325) ng/mL (p > .05). Serum soluble endothelial protein C receptor level is not elevated in children with sepsis, and it is not a prognostic parameter in septic children.
