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Critical Care
Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

Plasma fractalkine is a sustained marker of disease severity and outcome in sepsis patients

Authors: Arie J. Hoogendijk, Maryse A. Wiewel, Lonneke A. van Vught, Brendon P. Scicluna, Hakima Belkasim-Bohoudi, Janneke Horn, Aeilko H. Zwinderman, Peter M. C. Klein Klouwenberg, Olaf L. Cremer, Marc J. Bonten, Marcus J. Schultz, Tom van der Poll, on behalf of the MARS consortium

Published in: Critical Care | Issue 1/2015

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Abstract

Introduction

Fractalkine is a chemokine implicated as a mediator in a variety of inflammatory conditions. Knowledge of fractalkine release in patients presenting with infection to the Intensive Care Unit (ICU) is highly limited. The primary objective of this study was to establish whether plasma fractalkine levels are elevated in sepsis and associate with outcome. The secondary objective was to determine whether fractalkine can assist in the diagnosis of infection upon ICU admission.

Methods

Fractalkine was measured in 1103 consecutive sepsis patients (including 271 patients with community-acquired pneumonia (CAP)) upon ICU admission and at days 2 and 4 thereafter; in 73 ICU patients treated for suspected CAP in whom this diagnosis was refuted in retrospect; and in 5 healthy humans intravenously injected with endotoxin.

Results

Compared to healthy volunteers, sepsis patients had strongly elevated fractalkine levels. Fractalkine levels increased with the number of organs failing, were higher in patients presenting with shock, but did not vary by site of infection. Non-survivors had sustained elevated fractalkine levels when compared to survivors. Fractalkine was equally elevated in CAP patients and patients treated for CAP but in whom the diagnosis was retrospectively refuted. Fractalkine release induced by intravenous endotoxin followed highly similar kinetics as the endothelial cell marker E-selectin.

Conclusions

Plasma fractalkine is an endothelial cell derived biomarker that, while not specific for infection, correlates with disease severity in sepsis patients admitted to the ICU.
Appendix
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Metadata
Title
Plasma fractalkine is a sustained marker of disease severity and outcome in sepsis patients
Authors
Arie J. Hoogendijk
Maryse A. Wiewel
Lonneke A. van Vught
Brendon P. Scicluna
Hakima Belkasim-Bohoudi
Janneke Horn
Aeilko H. Zwinderman
Peter M. C. Klein Klouwenberg
Olaf L. Cremer
Marc J. Bonten
Marcus J. Schultz
Tom van der Poll
on behalf of the MARS consortium
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/s13054-015-1125-0

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