Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan.
Department of Anesthesiology, Fukuyama City Hospital, 5-23-1 Zaocho, Fukuyama, Hiroshima, 721-8511, Japan.
Sci Rep. 2021 May 13;11(1):10223. doi: 10.1038/s41598-021-89555-z.
Various biomarkers have been proposed for sepsis; however, only a few become the standard. We previously reported that plasma histidine-rich glycoprotein (HRG) levels decreased in septic mice, and supplemental infusion of HRG improved survival in mice model of sepsis. Moreover, our previous clinical study demonstrated that HRG levels in septic patients were lower than those in noninfective systemic inflammatory response syndrome patients, and it could be a biomarker for sepsis. In this study, we focused on septic patients and assessed the differences in HRG levels between the non-survivors and survivors. We studied ICU patients newly diagnosed with sepsis. Blood samples were collected within 24 h of ICU admission, and HRG levels were determined using an enzyme-linked immunosorbent assay. Ninety-nine septic patients from 11 institutes in Japan were included. HRG levels were significantly lower in non-survivors (n = 16) than in survivors (n = 83) (median, 15.1 [interquartile ranges, 12.7-16.6] vs. 30.6 [22.1-39.6] µg/ml; p < 0.01). Survival analysis revealed that HRG levels were associated with mortality (hazard ratio 0.79, p < 0.01), and the Harrell C-index (predictive power) for HRG was 0.90. These results suggested that HRG could be a novel prognostic biomarker for sepsis.
各种生物标志物已被提出用于脓毒症；然而，只有少数成为标准。我们之前报道过，脓毒症小鼠的血浆组氨酸丰富糖蛋白（HRG）水平降低，HRG 的补充输注可改善脓毒症小鼠模型的存活率。此外，我们之前的临床研究表明，脓毒症患者的 HRG 水平低于非感染性全身炎症反应综合征患者，并且它可能是脓毒症的一个生物标志物。在这项研究中，我们专注于脓毒症患者，并评估了非幸存者和幸存者之间 HRG 水平的差异。我们研究了新诊断为脓毒症的 ICU 患者。在入住 ICU 的 24 小时内采集血样，并使用酶联免疫吸附试验测定 HRG 水平。来自日本 11 个机构的 99 名脓毒症患者纳入本研究。非幸存者（n=16）的 HRG 水平明显低于幸存者（n=83）（中位数，15.1 [四分位距，12.7-16.6] vs. 30.6 [22.1-39.6] µg/ml；p<0.01）。生存分析表明 HRG 水平与死亡率相关（风险比 0.79，p<0.01），HRG 的 Harrell C 指数（预测能力）为 0.90。这些结果表明 HRG 可能是脓毒症的一种新型预后生物标志物。
