Decreased serum concentrations of sphingosine-1-phosphate in sepsis

作者：Martin Sebastian Winkler, Axel Nierhaus, M Holzmann, E. Mudersbach, Antonia Bauer, Linda Robbe, Corinne Zahrte, Maria Geffken, Sven Peine, Edzard Schwedhelm, Guenter Daum, Stefan Kluge, Christian Zoellner · 发表于：Critical Care · 年份：2015 · DOI：10.1186/s13054-015-1089-0 · 被引用次数：145 · 研究领域：Sphingolipid Metabolism and Signaling、Spondyloarthritis Studies and Treatments、Immune Response and Inflammation

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...