High C5a levels are associated with increased mortality in sepsis patients--no enhancing effect by actin-free Gc-globulin |
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Authors: | Gressner Olav A Koch Alexander Sanson Edouard Trautwein Christian Tacke Frank |
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Affiliation: | a Institute of Clinical Chemistry and Pathobiochemistry, University Hospital Aachen, Aachen University (RWTH), Aachen, Germany b Medical Clinic III, University Hospital Aachen, Aachen University (RWTH), Aachen, Germany |
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Abstract: | BackgroundImmune paralysis of phagocytic cells due to excess of the complement activation product C5a has been proposed as a critical pathomechanism in sepsis. In vitro studies suggest an interaction of C5a with Group-specific globulin (Gc-globulin).Study objectivesTo examine the predictive value of serum concentrations of both, C5a and actin-free Gc-globulin, and their ratio for prognosis (mortality) of critically ill patients.Patients154 critically ill (septic and non-septic) adult patients admitted to a Medical ICU and 38 healthy controls.MeasurementsActin-free Gc-globulin and C5a were measured on ICU admission, alongside extensive laboratory, clinical and prospective outcome measures.ResultsActin-free Gc-globulin and C5a serum concentrations were significantly reduced in critically ill patients compared with healthy controls. C5a levels, but not actin-free Gc-globulin, were significantly lower in patients with sepsis (n = 112) than in critically ill patients without sepsis (n = 42). C5a serum level was a prognostic parameter in patients with sepsis: High C5a levels were associated with increased mortality (at ICU and during follow-up). Although C5a and actin-free Gc-globulin were positively correlated, increasing serum concentrations of actin-free Gc-globulin did not enhance the C5a dependent effects in terms of prognosis or mortality in septic patients.ConclusionsInvestigation for C5a and/or actin-free Gc-globulin serum levels upon admission to the ICU may be helpful diagnostic tools. In patients with sepsis, C5a levels are an independent predictor of prognosis. However, different to pre-existing in vitro data, a clinically relevant interaction between actin-free Gc-globulin and C5a in terms of prognosis in severe inflammatory conditions is not given. |
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Keywords: | Actin-free Gc-globulin C5a Sepsis Prognosis |
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