THE ROLE OF PRESEPSIN IN IMMUNOSUPPRESSION IN SEPSIS AND SEPTIC SHOCK PATIENTS

Abstract

<h3>Introduction</h3> The role of presepsin (soluble CD14-ST) a 13-kDa cleavage product of DC14 receptor- is well described in the initial stage of the septic patients with little data on its role in immunosuppression. <h3>Methods</h3> 33 patients with sepsis (19 men and 14 women, age 57.1±19.9 years) and 6 patients with septic shock (2 men and 4 women, age 49.3±19.6 years) were assessed. Blood was obtained 3-4 days from diagnosis. The expression level of CD14 on monocytes was determined by flow cytometry. sCD14 was measured in serum in duplicate by ELISA. Expression of the CD14 gene was determined by real-time PCR. <h3>Results</h3> A significant decrease in the percentage of CD14-positive monocytes was revealed both in the group of patients with sepsis and in the group with septic shock (p<0.05) compared with normal donors. A significant increase in the level of sCD14 in the blood serum of patients with sepsis and septic shock was shown. The levels of sCD14 in patients with sepsis were inversely correlated with the percentage of CD14 on monocytes (R = -0.4588), indicating a weak inverse relationship. A significant decrease in the level of CD14 gene expression by monocytes was shown by 3.1 fold in patients with sepsis and by 10.2 fold in patients with septic shock compared with the control group. <h3>Conclusion</h3> The percentage of CD14 on monocytes, gene expression and the concentration of sCD14 in serum of patients with sepsis can serve as an indicator of the activity, severity and prognosis of sepsis.