Biomarkers of Necrotising Soft Tissue Infections Aspects of the Innate Immune Response.

The objective was to investigate aspects of the innate immune response in patients with NSTI, focusing on biomarkers as prognostic markers of disease severity and mortality. The overall hypothesis was that plasma biomarkers, representing the early innate immune response, can be used as prognostic markers of disease severity and mortality assessed by ICU scoring systems (SAPS II and SOFA score), the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, presence of septic shock, microbial aetiology, renal replacement therapy, and amputation.   In Study 1, we assessed the following acute-phase proteins in 135 patients with NSTI: pentraxin-3 (PTX3), procalcitonin, and C-reactive protein. We found that a high baseline PTX3 level above the median was significantly associated with the presence of septic shock, amputation, and 180-day mortality, albeit PTX3 was not an independent predictor of mortality. PTX3 and procalcitonin performed equally well, whereas C-reactive protein correlated poorly with clinically relevant outcomes.      In Study 2, we assessed the following plasma pattern recognition molecules in the same cohort as in Study 1: mannose-binding lectin, Ficolin-1, Ficolin-2, and Ficolin-3. We found that baseline Ficolin-2 level below the median was associated with short- and long-term mortality and correlated with the SAPS II, whereas low levels of mannose-binding lectin and Ficolin-3 were associated only with short-term mortality.   In Study 3, we asses...
Source: Danish Medical Journal - Category: General Medicine Tags: Dan Med J Source Type: research