Elevated levels of plasma hyaluronan in septicaemia

Area of Science:

• Biochemistry
• Immunology
• Critical Care Medicine

Background:

• Hyaluronan (hyaluronic acid) is cleared by liver sinusoidal endothelial cells, part of the reticulo-endothelial system (RES).
• Impaired RES function in severe infection and sepsis may elevate plasma hyaluronan.
• Hyaluronan metabolism is linked to systemic inflammation and organ dysfunction.

Purpose of the Study:

• To investigate plasma hyaluronan concentrations in patients with severe infection and septic shock.
• To correlate hyaluronan levels with disease severity and patient outcomes.
• To explore potential mechanisms behind altered hyaluronan levels during sepsis.

Main Methods:

• Plasma hyaluronan concentrations were measured in 44 patients with severe infection.
• Patients were categorized into: severe infection without septic shock, septic shock survivors, and septic shock non-survivors.
• Measurements were taken at disease onset and twice during the subsequent 2-3 days.

Main Results:

• Patients with severe infection without septic shock had higher hyaluronan levels than controls on day 1.
• Septic shock patients (survivors and non-survivors) exhibited significantly elevated hyaluronan levels compared to controls and non-shock patients.
• Septic shock non-survivors had markedly higher hyaluronan concentrations than survivors.

Conclusions:

• Elevated plasma hyaluronan is associated with severe infection and septic shock.
• Fatal septic shock correlates with significantly higher hyaluronan levels.
• Potential causes include increased hyaluronan release or decreased hepatic clearance.