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Serial change of C1 inhibitor in patients with sepsis: a prospective observational study

Tomoya Hirose1, Hiroshi Ogura1, Hiroki Takahashi1

  • 1Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871 Japan.

Journal of Intensive Care
|July 14, 2018
PubMed

Insights

C1 inhibitor (C1-INH) levels were lower in patients with refractory septic shock, particularly non-survivors, on admission and day 1. These findings highlight C1-INH

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Biochemistry

Background:

  • C1 inhibitor (C1-INH) is a key regulator of complement, kallikrein-kinin, fibrinolytic, and coagulation systems.
  • C1-INH possesses anti-inflammatory and vascular permeability regulating functions.
  • Understanding C1-INH dynamics in sepsis is crucial for managing inflammatory responses.

Purpose of the Study:

  • To investigate the serial changes in C1-INH activity in sepsis patients.
  • To assess the relationship between C1-INH levels and septic shock severity.

Main Methods:

  • A single-center, prospective, observational study involving 40 sepsis patients.
  • Serial measurement of C1-INH activity over 14 days.
  • Classification of patients into non-shock, non-refractory shock, and refractory shock groups.

Main Results:

  • Refractory shock patients exhibited lower C1-INH activity on admission and day 1 compared to other groups.
  • C1-INH levels increased significantly over time in non-shock and non-refractory shock groups (p < 0.0001).
  • Non-survivors in the refractory shock group showed no significant increase in C1-INH during the clinical course (p = 0.0690).

Conclusions:

  • Lower C1-INH activity on admission and day 1 is associated with refractory septic shock.
  • C1-INH levels may serve as a prognostic marker in sepsis, especially in severe shock cases.
  • Further research is warranted to explore therapeutic modulation of C1-INH in sepsis.
Abstract

Keywords:
C1 inhibitor (C1-INH)SepsisShockVascular permeability

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