Abstract
Background There is a pressing need for specific prognostic markers that could be used to monitor the severity of sepsis. The aims of our study were to investigate changes in the expression of different molecular forms of fibronectin in sepsis and to assess their relationship to the clinical severity and mortality of patients. Material and Methods. Forms of fibronectin: plasma (pFN), cellular (EDA-FN), FN-fibrin complexes, and fibronectin fragments were analyzed in 71 sepsis patients (survivors and nonsurvivors) and in the control by ELISA and immunoblotting. Results The baseline pFN concentration of patients with sepsis was significantly lower than in the control (133.0 mg/L vs. 231.2 mg/L) (P < 0.001), and in nonsurvivors, it was lower than in survivors (106.0 mg/L vs. 152.8 mg/L) (P = 0.004). The baseline EDA-FN was significantly elevated in both sepsis groups (survivors: 6.7 mg/L; nonsurvivors: 9.4 mg/L) compared to the control (1.4 mg/L) (P < 0.001). It should be noted that among patients with more severe sepsis, the EDA-FN level was higher in nonsurvivors than in survivors. Furthermore, molecular FN-fibrin complexes as well as FN fragments occurred much more frequently in nonsurvivors than in survivors. Conclusion The study showed that in sepsis, changes in plasmatic and cellular form of fibronectin were associated with the severity of sepsis and may be useful predictors of outcome.
Highlights
Sepsis is life-threatening organ dysfunction resulting from a dysregulated host response to infection [1]
The severity of sepsis on admission to the ICU was determined based on the APACHE II and SOFA scores; a higher score indicated that the patient was in a worse condition
It was shown that the plasma fibronectin (pFN) concentration in survivors was markedly higher than that in nonsurvivors in all APACHE II and SOFA ranges, and EDA-FN concentration was lower in survivors than in nonsurvivors
Summary
Sepsis is life-threatening organ dysfunction resulting from a dysregulated host response to infection [1]. Our previous studies showed that coagulation abnormalities are present in a majority of patients with sepsis and are associated with a significantly higher mortality rate [4]. The aims of our study were to investigate changes in the expression of different molecular forms of fibronectin in sepsis and to assess their relationship to the clinical severity and mortality of patients. Forms of fibronectin: plasma (pFN), cellular (EDA-FN), FN-fibrin complexes, and fibronectin fragments were analyzed in 71 sepsis patients (survivors and nonsurvivors) and in the control by ELISA and immunoblotting. The study showed that in sepsis, changes in plasmatic and cellular form of fibronectin were associated with the severity of sepsis and may be useful predictors of outcome
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