Abstract
Background: The results of several studies have suggested that infections and sepsis, either bacterial or viral, might be associated with elevated plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels. Since there are no data on PCSK9 levels and antibiotic resistance or the severity of disease in patients with bacterial infections in intensive care units, the aim of this study was to investigate whether any such associations exist. Methods: 100 patients (46 males, mean age 67.12 ± 1.34 years) with bacterial infections who were staying in an intensive care unit (ICU) longer than 48 h but less than 7 days and who were not receiving corticosteroids were analyzed. Their serum levels of albumin, C-reactive protein, glucose, lactate, blood urea nitrogen, prothrombin (international normalized ratio), total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, PCSK9, and procalcitonin were measured. The severity of the patients’ condition was assessed by using the Glasgow Coma Scale (GCS), the Sequential Organ Failure Assessment (SOFA), and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scales. Results: Using a hierarchical regression modeling approach, no significant association was found between PCSK9 levels and either the severity of disease (APACHE II, SOFA, and GCS) indices or resistance to antibiotics. Conclusion: The results suggest that there is no association between PCSK9 levels and resistance to antibiotics or the condition of patients hospitalized in intensive care units.
Highlights
Enzymes belonging to the proprotein convertase subtilisin/kexin (PCSKs) family are involved in the pathophysiology of different diseases, such as atherosclerosis, viral and bacterial infections, cancer, obesity, diabetes, Alzheimer’s disease, hypertension, arthritis, and even multiple trauma [1,2,3,4,5]
Gram-negative bacteria were isolated from 97% of patients, and among them Klebsiella sp., Pseudomonas aeruginosa, and Acinetobacter were the most frequent
The results of some studies have indicated that inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9) function may be an effective treatment option for both gram-positive and gram-negative sepsis [30]. Despite all these quite convincing data indicating that serious infections and sepsis might be associated with elevated plasma PCSK9 levels, it seems that there is no association between PCSK9 levels and resistance to antibiotics or the condition of patients hospitalized in intensive care units
Summary
Enzymes belonging to the proprotein convertase subtilisin/kexin (PCSKs) family are involved in the pathophysiology of different diseases, such as atherosclerosis, viral and bacterial infections, cancer, obesity, diabetes, Alzheimer’s disease, hypertension, arthritis, and even multiple trauma [1,2,3,4,5]. On the basis of this, PCSK9 antibodies, more often called PCSK9 inhibitors, have been developed They increase LDLR density on the surface of hepatocytes and thereby significantly decrease the levels of elevated LDL cholesterol in circulation [6,7]. Methods: 100 patients (46 males, mean age 67.12 ± 1.34 years) with bacterial infections who were staying in an intensive care unit (ICU) longer than 48 h but less than 7 days and who were not receiving corticosteroids were analyzed Their serum levels of albumin, C-reactive protein, glucose, lactate, blood urea nitrogen, prothrombin (international normalized ratio), total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, PCSK9, and procalcitonin were measured. Results: Using a hierarchical regression modeling approach, no significant association was found between
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