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Early released lipid-soluble cardiodepressant factor and elevated oestrogenic substances in human septic shock
Insights
A novel cardiodepressant factor (CDF) was found in septic shock patients, linked to elevated oestrone levels. Oestrone levels may serve as a key indicator for assessing septic shock severity.
Area of Science:
- Biochemistry
- Cardiology
- Endocrinology
Background:
- Septic shock is a life-threatening condition with high mortality.
- Cardiodepressant factors (CDFs) in septic shock can impair heart function.
- The exact nature and origin of CDFs remain incompletely understood.
Purpose of the Study:
- To identify and characterize a cardiodepressant factor (CDF) in septic shock patients.
- To investigate the relationship between CDF and steroid hormone levels.
- To evaluate the potential of steroid hormone measurements as prognostic markers for septic shock.
Main Methods:
- Isolation and partial characterization of CDF from patient serum.
- Chromatographic analysis to determine CDF properties.
- Immunological quantification of oestrone, oestradiol, and cortisol using radioimmunoassay.
Main Results:
- A heat-stable CDF with molecular weight under 1000 was identified in the lipid-soluble fraction of septic shock patient sera.
- CDF exhibited oestrone-like chromatographic behavior.
- Elevated levels of oestrone, oestradiol, and cortisol were observed in septic shock patients, with the highest concentrations in non-survivors.
- Oestrone levels showed the most significant elevation, particularly in males.
Conclusions:
- A strong correlation exists between the cardiodepressant factor and oestrone.
- While oestrone is related to CDF, it is not the direct CDF itself.
- Radioimmunoassay of oestrone can serve as a valuable prognostic index for evaluating septic shock severity.
Abstract:
A cardiodepressant factor (CDF) able to decrease contractile activity of cultured rat heart cells was determined to be located in the lipid-soluble fraction of sera from men in septic shock. This heat-stable CDF has a molecular weight under 1000. Repeated fractionations of sera gave evidence of an oestrone-like chromatographic behaviour. Oestrone, oestradiol and cortisol were immunologically quantified in two groups (recovery and death) of men in septic shock. All of them were elevated in sera from patients with shock. Highest levels of oestrone 4330 pmol 1(-1), (SEM +/- 851, n = 15), oestradiol 1030 pmol 1(-1), (SEM +/- 220, n = 15) and cortisol 1096 pmol 1(-1), (SEM +/- 94, n = 15), were found in patients who failed to recover from shock. However, oestrone levels were the most striking, especially in the male. This study gives evidence for a polarity relationship between the CDF and oestrone, but natural oestrone does not appear to be a direct CDF. Moreover, this study shows that radioimmunoassay of oestrone could be an important index evaluating the severeness of septic shock.