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Critical Care
Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

Decreased serum concentrations of sphingosine-1-phosphate in sepsis

Authors: Martin Sebastian Winkler, Axel Nierhaus, Maximilian Holzmann, Eileen Mudersbach, Antonia Bauer, Linda Robbe, Corinne Zahrte, Maria Geffken, Sven Peine, Edzard Schwedhelm, Guenter Daum, Stefan Kluge, Christian Zoellner

Published in: Critical Care | Issue 1/2015

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Abstract

Introduction

Sphingosine-1-phosphate (S1P) is a signaling lipid that regulates pathophysiological processes involved in sepsis progression, including endothelial permeability, cytokine release, and vascular tone. The aim of this study was to investigate whether serum-S1P concentrations are associated with disease severity in patients with sepsis.

Methods

This single-center prospective-observational study includes 100 patients with systemic inflammatory response syndrome (SIRS) plus infection (n = 40), severe sepsis (n = 30), or septic shock (n = 30) and 214 healthy blood donors as controls. Serum-S1P was measured by mass spectrometry. Blood parameters, including C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), lactate, and white blood cells (WBCs), were determined by routine assays. The Sequential Organ Failure Assessment (SOFA) score was generated and used to evaluate disease severity.

Results

Serum-S1P concentrations were lower in patients than in controls (P < 0.01), and the greatest difference was between the control and the septic shock groups (P < 0.01). Serum-S1P levels were inversely correlated with disease severity as determined by the SOFA score (P < 0.01) as well as with IL-6, PCT, CRP, creatinine, lactate, and fluid balance. A receiver operating characteristic analysis for the presence or absence of septic shock revealed equally high sensitivity and specificity for S1P compared with the SOFA score. In a multivariate logistic regression model calculated for prediction of septic shock, S1P emerged as the strongest predictor (P < 0.001).

Conclusions

In patients with sepsis, serum-S1P levels are dramatically decreased and are inversely associated with disease severity. Since S1P is a potent regulator of endothelial integrity, low S1P levels may contribute to capillary leakage, impaired tissue perfusion, and organ failure in sepsis.
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Metadata
Title
Decreased serum concentrations of sphingosine-1-phosphate in sepsis
Authors
Martin Sebastian Winkler
Axel Nierhaus
Maximilian Holzmann
Eileen Mudersbach
Antonia Bauer
Linda Robbe
Corinne Zahrte
Maria Geffken
Sven Peine
Edzard Schwedhelm
Guenter Daum
Stefan Kluge
Christian Zoellner
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-1089-0

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