High phosphoserine in sepsis: panel of clinical and plasma amino acid correlations

The determination of plasma phosphoserine concentration in sepsis is uncommon, and the clinical and metabolic correlations of abnormally high phosphoserine are basically unknown. We analyzed 430 determinations of phosphoserine, other amino acid (AA) levels and ancillary variables obtained in 18 septic patients, in order to assess the biochemical and clinical correlations of changes in phosphoserine. Phosphoserine ranged between 5 and 55 micromol/L (n.v. < 12). Increasing phosphoserine was associated with higher severity of illness and death, and its best AA correlates were increasing cystathionine, 3-methylhistidine, histidine, hydroxyproline and tyrosine (r > 0.65, p < 0.001 for all). High phosphoserine seemed to cumulatively reflect kidney and liver dysfunction and enhanced proteolysis. As a collateral finding, 3-methylhistidine (a best correlate of phosphoserine) was also inversely related to nutritional AA dose (p < 0.001). These data suggest that in septic patients the determination of plasma phosphoserine may provide useful information on severity of septic illness and prognosis. The observed correlations also indirectly evidenced an impact of nutritional AA dose in moderating proteolysis.