Abstract
ABSTRACTObjectiveThe outcomes of sepsis and septic shock patients are heterogonous, with avariable response despite standardized care. The aim of this study was toexplore the racial differences in septic shock outcomes, and theirassociation with genetic polymorphisms and cytokine levels in an Asianpopulation.Materials and methodsThis was an observational cohort study with Intensive Care units of a 500bedded tertiary care hospital in Singapore. 198 patients (73 Chinese, 73Malay and 52 Indian and others) admitted to the Khoo Teck Puat HospitalIntensive Care Unit between August 2016 and June 2017, with a diagnosis ofsevere sepsis (according to) were enrolled. Plasma interlukin-6 (IL-6),interlukin-10 (IL-10) and tumour necrosis factor-a (TNFa) were measuredusing a highly sensitive quantitative sandwich enzyme-linked immunosorbentassay (ELISA) (BioVendor, Modrice, Czech Republic). The gene panel studiedincluded 16 genes.ResultsThe rs7038903 common variant in SVEP1 gene showed significant associationwith sepsis severity independent of other variants in ordinal logistic andlinear regression model (p = 0.001 and p = 0.002 respectively). Moreover, the association between rs7038903 and increased hazard for death remained significant after further adjusting for cytokines level. Interestingly, significant differences were seen in plasma IL6 inindividuals with or without rs7038903 C allele (28pg/ml (IQR 12-86) vs90pg/ml (IQR 49-155); P=0.022) in patients with severe sepsis in the Malayethnic group.ConclusionOur study shows a promising polymorphism in SVEP1 gene (rs7038903) which isassociated with sepsis shock and 28 days mortality, independent of age, gender, and method of diagnosis and SOFA score. Collectively, while our findings so far have shown the additional value or measuring cytokines andgenetic markers in sepsis outcomes in the local population, further largescare studies are needed in a heterogeneous septic population with arigorous analysis to know the significance of our findings.How to cite this articleSiddiqui S, Gurung RL et al. Genetic Polymorphisms and Cytokine Profile of Different Ethnicities in Septic Shock Patients, and their Association with Mortality. Indian J Crit Care Med 2019;29(3):135-138.
Highlights
IntroductionSepsis and septic shock remain leading causes of death globally, with a mortality rate close to 50%1
Our study shows a promising polymorphism in SVEP1 gene which is associated with sepsis shock and 28 days mortality, independent of age, gender, and method of diagnosis and SOFA score
While our findings so far have shown the additional value or measuring cytokines and genetic markers in sepsis outcomes in the local population, further large scare studies are needed in a heterogeneous septic population with a rigorous analysis to know the significance of our findings
Summary
Sepsis and septic shock remain leading causes of death globally, with a mortality rate close to 50%1. Sepsis is a multifactorial syndrome, with a complex pro-inflammatory response leading to high morbidity and mortality. The outcomes of sepsis and septic shock patients are heterogonous, with a variable response despite standardized care. Racial variation in septic shock and mortality has been well documented. Less is known about racial disparities among patients with sepsis and septic shock in a multi-ethnic Asian population. Singapore is composed of a predominantly Chinese population with a mix of Malay and Indians as well as foreigners. This ethnic mix produces an interesting cohort for such a study
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