The Prognostic Value of suPAR Compared to Other Inflammatory Markers in Patients with Severe Sepsis

Anna Gustafsson, Lennart Ljunggren, Mikael Bodelsson, Ingrid Berkestedt, Anna Gustafsson, Lennart Ljunggren, Mikael Bodelsson, Ingrid Berkestedt

Abstract

It has been suggested that soluble urokinase plasminogen activator (suPAR) can be used as a marker of disease severity and risk of mortality in sepsis. The aim with the present study was to compare plasma levels of suPAR in patients with severe sepsis to control subjects and correlate it with the level of inflammatory activation, severity and mortality. Samples were collected from 27 sepsis patients at the intensive care unit (ICU), Lund, Sweden; 90-day mortalities were registered. The suPAR level was significantly elevated in sepsis patients compared to controls, but not significantly higher in nonsurvivors than survivors. Plasma levels of suPAR did correlate weakly with the SOFA score and myeloperoxidase (MPO) but not with CRP, PCT, IL-6 or IL-10 in patients with severe sepsis. The weak correlation between suPAR and other inflammatory markers might suggest that suPAR reflects general activation of the immune system rather than exerting inflammatory actions.

Keywords: SIRS; inflammatory markers; sepsis; soluble urokinase plasminogen activator receptor; suPAR.

Figures

Figure 1
Figure 1
Plasma levels of suPAR in patients with severe sepsis, and controls. Notes:P-values refer to statistically significant differences in median levels of sepsis patients compared to controls, between deceased and surviving sepsis patients at 90 days after admission or of sepsis patients at day 4 compared to the day of admission. The circles represent individual patients and the median is indicated with a horizontal line. In (C), open circles represent surviving patients. Abbreviation: n.s., not significant.
Figure 2
Figure 2
Correlation between suPAR and CRP (A, P = 0.53, r = 0.15), IL-6 (B, P = 0.84, r = 0.040), IL-10 (C, P = 0.93, r = 0.019), and PCT (D, P = 0.98, r = 0.0062), respectively. Notes: The red circles represent sepsis patients and the blue circles controls. CRP was not measured in the controls.
Figure 3
Figure 3
Correlation between suPAR and total SOFA score (A, P = 0.05, r = 0.43) and MPO (B, P = 0.05, r = 0.39), respectively.

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