Abstract

BackgroundA practical strategy to discover sepsis specific proteins may be to compare the plasma peptides and proteins from patients in the intensive care unit with and without sepsis. The aim was to discover proteins and/or peptides that show greater observation frequency and/or precursor intensity in sepsis. The endogenous tryptic peptides of ICU-Sepsis were compared to ICU Control, ovarian cancer, breast cancer, female normal, sepsis, heart attack, Alzheimer’s and multiple sclerosis along with their institution-matched controls, female normals and normal samples collected directly onto ice.MethodsEndogenous tryptic peptides were extracted from individual sepsis and control EDTA plasma samples in a step gradient of acetonitrile for random and independent sampling by LC–ESI–MS/MS with a set of robust and sensitive linear quadrupole ion traps. The MS/MS spectra were fit to fully tryptic peptides within proteins using the X!TANDEM algorithm. The protein observation frequency was counted using the SEQUEST algorithm after selecting the single best charge state and peptide sequence for each MS/MS spectra. The protein observation frequency of ICU-sepsis versus ICU Control was subsequently tested by Chi square analysis. The average protein or peptide log10 precursor intensity was compared across disease and control treatments by ANOVA in the R statistical system.ResultsPeptides and/or phosphopeptides of common plasma proteins such as ITIH3, SAA2, SAA1, and FN1 showed increased observation frequency by Chi square (χ2 > 9, p < 0.003) and/or precursor intensity in sepsis. Cellular gene symbols with large Chi square values from tryptic peptides included POTEB, CTNNA1, U2SURP, KIF24, NLGN2, KSR1, GTF2H1, KIT, RPS6KL1, VAV2, HSPA7, SMC2, TCEB3B, ZNF300, SUPV3L1, ADAMTS20, LAMB4, MCCC1, SUPT6H, SCN9A, SBNO1, EPHA1, ABLIM2, cB5E3.2, EPHA10, GRIN2B, HIVEP2, CCL16, TKT, LRP2 and TMF1 amongst others showed increased observation frequency. Similarly, increased frequency of tryptic phosphopeptides were observed from POM121C, SCN8A, TMED8, NSUN7, SLX4, MADD, DNLZ, PDE3B, UTY, DEPDC7, MTX1, MYO1E, RXRB, SYDE1, FN1, PUS7L, FYCO1, USP26, ACAP2, AHI1, KSR2, LMAN1, ZNF280D and SLC8A2 amongst others. Increases in mean precursor intensity in peptides from common plasma proteins such as ITIH3, SAA2, SAA1, and FN1 as well as cellular proteins such as COL24A1, POTEB, KANK1, SDCBP2, DNAH11, ADAMTS7, MLLT1, TTC21A, TSHR, SLX4, MTCH1, and PUS7L among others were associated with sepsis. The processing of SAA1 included the cleavage of the terminal peptide D/PNHFRPAGLPEKY from the most hydrophilic point of SAA1 on the COOH side of the cystatin C binding that was most apparent in ICU-Sepsis patients compared to all other diseases and controls. Additional cleavage of SAA1 on the NH2 terminus side of the cystatin binding site were observed in ICU-Sepsis. Thus there was disease associated variation in the processing of SAA1 in ICU-Sepsis versus ICU controls or other diseases and controls.ConclusionSpecific proteins and peptides that vary between diseases might be discovered by the random and independent sampling of multiple disease and control plasma from different hospital and clinics by LC–ESI–MS/MS for storage in a relational SQL Server database and analysis with the R statistical system that will be a powerful tool for clinical research. The processing of SAA1 may play an unappreciated role in the inflammatory response to Sepsis.

Highlights

  • Analysis of septic blood by mass spectrometry The analysis of septic blood proteins has been recently reviewed, and to date some 198 proteins have been characterized in response to septic infection [1]

  • Specific proteins and peptides that vary between diseases might be discovered by the random and independent sampling of multiple disease and control plasma from different hospital and clinics by LC–ESI–MS/MS for storage in a relational SQL Server database and analysis with the R statistical system that will be a powerful tool for clinical research

  • Materials Anonymous human EDTA plasma with no identifying information were received and analyzed under the Ryerson Ethical Review Board Protocol REB 2015-207: Intensive Care Unit (ICU)-Sepsis versus ICU Control EDTA plasma were obtained from Clinical Evaluation Research Unit, Kingston General Hospital, Kingston Ontario Canada; Ovarian and breast cancer samples were obtained from the Ontario Tumor bank of the Ontario Institute of Cancer Research, Toronto Ontario; Heart attack versus pre-operative orthopedic surgery controls were obtained from St Joseph’s Hospital of McMaster University; Multiple sclerosis Alzheimer’s dementia and institution-matched normals were obtained from Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; In addition, EDTA plasma samples collected onto ice as a baseline degradation controls were obtained from Integrated Biobank of Luxembourg (IBBL) Luxembourg [39, 40]

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Summary

Introduction

Analysis of septic blood by mass spectrometry The analysis of septic blood proteins has been recently reviewed, and to date some 198 proteins have been characterized in response to septic infection [1]. Plasma from systemic inflammatory response syndrome versus sepsis patients were compared by LC/LC–ESI–MS/MS that showed increased observation frequency for C4, CRP, plasminogen precursor, apolipoprotein A-II, plasma protease C1 inhibitor precursor, transthyretin precursor, while serum amyloid P-component precursor, apolipoprotein A-I precursor, antithrombin-III precursor, and serum amyloid A-4 protein precursor showed lower observation frequency [8]. A study of 300 septic and non-septic patients showed that the combination of age and gender with CRP and PCT levels could yield a positive diagnosis of sepsis [13]. Cell based markers such as soluble TREM1 and neutrophil CD64 expression showed some utility for sepsis diagnosis [14]. The endogenous tryptic peptides of ICU-Sepsis were compared to ICU Control, ovarian cancer, breast cancer, female normal, sepsis, heart attack, Alzheimer’s and multiple sclerosis along with their institution-matched controls, female normals and normal samples collected directly onto ice

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