Yokoyama Yayoi, Ito Takashi, Yasuda Tomotsugu, Furubeppu Hiroaki, Kamikokuryo Chinatsu, Yamada Shingo, Maruyama Ikuro, Kakihana Yasuyuki
1Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544 Japan.
2Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Thromb J. 2019 Jan 14;17:1. doi: 10.1186/s12959-018-0190-4. eCollection 2019.
Nuclear histone proteins are released into the extracellular space, and act as major mediators of coagulopathy and remote organ failure in septic animals. However, the circulating histone levels in septic patients have not been precisely quantified.
Using a novel enzyme-linked immunosorbent assay for histone H3 detection, we measured the serum histone H3 levels in 85 patients admitted to the intensive care unit because of infectious diseases. We then evaluated the associations of circulating histone H3 levels with organ failure, coagulopathy, and mortality.
Circulating histone H3 levels were significantly higher in patients with coagulopathy, and were positively correlated with numbers of organ failures. Circulating histone H3 levels were also associated with fatal outcome. Receiver-operating characteristic analyses revealed that the predictive performance of circulating histone H3 levels for mortality was higher than that of conventional inflammatory markers, including white blood cell count, C-reactive protein, and cell-free DNA.
Circulating histone H3 levels are associated with coagulopathy, multiple organ failure, and death in patients requiring intensive care because of infectious diseases.
核组蛋白可释放至细胞外空间，是脓毒症动物凝血病及远隔器官功能障碍的主要介质。然而，脓毒症患者循环组蛋白水平尚未得到精确量化。
采用一种新型酶联免疫吸附测定法检测组蛋白H3，我们测量了85例因感染性疾病入住重症监护病房患者的血清组蛋白H3水平。然后，我们评估了循环组蛋白H3水平与器官功能障碍、凝血病及死亡率之间的关联。
凝血病患者的循环组蛋白H3水平显著更高，且与器官功能障碍数量呈正相关。循环组蛋白H3水平也与致命结局相关。受试者工作特征分析显示，循环组蛋白H3水平对死亡率的预测性能高于传统炎症标志物，包括白细胞计数、C反应蛋白及游离DNA。
因感染性疾病需要重症监护的患者，其循环组蛋白H3水平与凝血病、多器官功能障碍及死亡相关。
