Abstract
Background There is still no information on the dynamics of pro- and anti-inflammatory cytokines and mark-ers of the septic process before the clinical manifestation of sepsis. The aim of the study was to analyze the dynamics of inflammation and sepsis markers concentration in early periods in patients with urgent pathology, depending on the subsequently developed sepsis. Materials and methods. The concentration of procalcitonin, C-reactive protein, LBP, IL-6, IL-10, IL-2R in 61 patients with a high risk of sepsis was investigated starting from the first day after admission to the hospital and then with intervals of 3–5 days. The Group 1 included 29 patients with verified sepsis. All patients of this group survived. The Group 2 included 8 patients who died. The Group 3 included 24 patients who had no clinical signs of sepsis. All the patients in this group recovered. Results. We revealed significant differences in concentrations of systemic inflammatory response markers and its dynamics in the period preceding clinical manifestations of sepsis. It was found that it was possible to predict the development of sepsis and its unfavorable outcome with a high statistical probability in the study of paired samples of blood serum of patients received on day 1–3 and 4–6 from the onset of the disease or severe trauma. The predictors were multidirectional changes of IL-6, IL-10, LBP concentrations and more than three-fold IL-2R increase on the background of high concentrations of procalcitonin and C-reactive protein. Conclusion. The highest concentrations of procalcitonin, C-reactive protein, IL-10 and IL-2R were revealed within the first three days in patients who died of sepsis. High concentrations of IL-6 and IL-10 within first three days and different directions of their concentrations during the next 4–6 days indicate the development of sepsis with an unfavorable outcome. Reduction of IL-2R and IL-6 and an increase in IL-10 within the first week after the onset of the disease or trau-ma are predictors of lethal outcome.
Highlights
Despite numerous studies devoted to determining the diagnostic and prognostic significance of biomarkers associated with the development of sepsis, there is still no consensus on interpreting their results
The increase in reference values of procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10), lipopolysaccharide-binding peptide (LPSBP) and soluble interleukin-2 receptor (IL-2R) in the early period is described in a number of works
The purpose of this article was to study the dynamics of concentrations of inflammatory and septic markers in early periods in patients with urgent confition, depending on the subsequently developed sepsis
Summary
Despite numerous studies devoted to determining the diagnostic and prognostic significance of biomarkers associated with the development of sepsis, there is still no consensus on interpreting their results. The main difficulty is tha concentrations of many marker molecules significantly increase with the development of sepsis, and in the first 2 days from the onset of acute inflammatory disease or immediately after a mechanical trauma, burn injury or extensive surgical intervention even in patients who did not have septic complications in later terms. A favorable course of the disease is accompanied by a fall in their level to normal values within 2-3 days, and a multiple increase in later periods is noted only in case of infection and the development of sepsis [1,2,3,4]. The concentration of mediators in the peripheral blood varies with the activity of the inflammatory process, but an excessively high level of cytokines can promote the development of severe multi-organ dysfunction and sepsis. THE AIM OF THE STUDY was to analyze the dynamics of inflammation and sepsis markers concentration in early periods in patients with urgent pathology, depending on the subsequently developed sepsis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
