Abstract
BackgroundTenascin-C is a pro-inflammatory glycoprotein with various biological functions. High expression of tenascin-C is found in inflammation, tissue remodeling, and autoimmune diseases. However, its expression and clinical significance in sepsis remain unclear. This study was designed to investigate the relationship between serum tenascin-C levels and disease severity and prognosis in patients with sepsis.MethodsA total of 167 patients with sepsis admitted to the ICU were enrolled. Lood samples were collected within 24 h of admission. Serum tenascin-C levels were measured by enzyme-linked immunosorbent assay (ELISA). Follow-up was performed to observe 30-day mortality.ResultsSerum tenascin-C levels were significantly elevated in patients with sepsis compared with non-sepsis controls (P < 0.001). Serum tenascin-C levels were higher in nonsurvivors (58 cases) who died within 30 days (34.5%) compared to survivors (109 cases) (P < 0.001). In patients with sepsis, serum tenascin-C levels were significantly positively correlated with SOFA scores (P = 0.011), serum creatinine (P = 0.006), C-reactive protein (CRP) (P = 0.001), interleukin-6 (IL-6) (P < 0.001), and tumor necrosis factor α (TNF-α) (P = 0.026). Logistic multivariate regression models showed that serum tenascin-C levels were independent contributor of 30-day mortality. Kaplan-Meier curves showed that septic patients with high levels of serum tenascin-C (≥56.9 pg/mL) had significantly higher 30-day mortality than those with lower serum tenascin-C (< 56.9 pg/mL) (P < 0.001).ConclusionElevated serum tenascin-C was found in septic patients and associated with severity and poor prognosis.
Highlights
Tenascin-C is a pro-inflammatory glycoprotein with various biological functions
Patients in the nonsurvivors group had significantly higher age (P = 0.024), Sepsis-related Organ Failure Assessment (SOFA) scores (P < 0.001), serum creatinine (P = 0.001), lactic acid (P = 0.008), C-reactive protein (CRP) (P = 0.010), IL-6 (P = 0.010), and tumor necrosis factor α (TNF-α) (P = 0.001) levels compared with survivors
There was no significant difference in serum tenascin-C between patients with and without ventilator (Fig. 2c), and between patients with and without septic shock (Fig. 2d)
Summary
Tenascin-C is a pro-inflammatory glycoprotein with various biological functions. High expression of tenascin-C is found in inflammation, tissue remodeling, and autoimmune diseases. This study was designed to investigate the relationship between serum tenascinC levels and disease severity and prognosis in patients with sepsis. Sepsis is a systemic inflammatory response caused by infection and has a high risk of multiple organ dysfunction syndrome (MODS) and death [1]. It is currently believed that severe sepsis causes systemic inflammatory response syndrome (SIRS) and has a compensatory anti-inflammatory response [2]. The complex interaction between pro-inflammatory and anti-inflammatory responses determines the outcome of sepsis [3]. Tenascin-C enhances the synthesis of pro-inflammatory cytokines in macrophages that is activated by LPS through toll-like receptor 4 (TLR4), while inhibiting the synthesis of
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