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Decreased plasma concentrations of apolipoprotein M in sepsis and systemic inflammatory response syndromes

Sunil B Kumaraswamy1, Adam Linder, Per Åkesson

  • 1Department of Laboratory Medicine, Division of Clinical Chemistry, Lund University, Skåne University Hospital, Entrance 46, Malmö, SE-20502, Sweden.

Critical Care (London, England)
|April 20, 2012
PubMed
Abstract

Insights

Plasma concentrations of apolipoprotein M (apoM) significantly decrease during sepsis and systemic inflammatory response syndrome (SIRS). Lower apoM levels correlate with disease severity, potentially contributing to vascular leakage.

Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Immunology

Background:

  • Apolipoprotein M (apoM) is a protein found in high-density lipoprotein (HDL) particles.
  • It serves as a carrier for sphingosine-1-phosphate (S1P), crucial for maintaining vascular barrier integrity.
  • Understanding apoM levels in inflammatory conditions is vital for assessing disease progression and potential complications.

Purpose of the Study:

  • To quantify plasma concentrations of apoM in patients with sepsis and SIRS.
  • To investigate the correlation between apoM levels and other biomarkers such as apolipoprotein A-I (apoA1), apolipoprotein B (apoB), and cholesterol levels (HDL, LDL).
  • To determine if apoM acts as an acute-phase reactant in these conditions.

Main Methods:

  • Plasma samples were collected from distinct patient groups: severe sepsis with shock, severe sepsis without shock, sepsis, infections without SIRS, and SIRS without infection.
  • Concentrations of apoM, apoA1, and apoB were measured using enzyme-linked immunosorbent assays (ELISAs).
  • Total, HDL-, and LDL-cholesterol levels were determined using a commercial assay.

Main Results:

  • ApoM concentrations showed a negative correlation with acute-phase markers, indicating it functions as a negative acute-phase protein.
  • Significantly decreased apoM levels were observed across all patient groups compared to controls, with the most pronounced reduction in severe sepsis.
  • ApoM levels strongly correlated with apoA1, apoB, HDL-cholesterol, and LDL-cholesterol levels, which were also generally reduced in patient groups.

Conclusions:

  • Plasma apoM concentrations decrease dramatically during sepsis and SIRS, with the extent of reduction reflecting disease severity.
  • The diminished levels of apoM, a carrier of the vascular-protective S1P, may contribute to the increased vascular permeability characteristic of sepsis and SIRS.
  • ApoM's behavior as a negative acute-phase protein warrants further investigation in the context of inflammatory diseases.

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