The Role of Osteopontin as a Diagnostic and Prognostic Biomarker in Sepsis and Septic Shock
The Role of Osteopontin as a Diagnostic and Prognostic Biomarker in Sepsis and Septic Shock
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DOI：
10.3390/cells8020174
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发表时间：
2019-02-01
期刊：
影响因子：
6
通讯作者：
Chiocchetti, Annalisa
中科院分区：
文献类型：
--
作者：
Castello, Luigi Mario;Baldrighi, Marco;Chiocchetti, Annalisa
脓毒症是由宿主对感染的反应失调引起的危及生命的器官功能障碍。骨桥蛋白（OPN）是一种参与炎症反应的细胞外基质蛋白。我们的目的是评价急诊科（艾德）单次OPN测定对脓毒症的诊断和预后的作用。我们在意大利艾德进行了一项单中心前瞻性观察性研究，其中我们招募了102名疑似感染且qSOFA >= 2的连续患者。发现OPN血浆浓度是脓毒症的独立预测因子（OR = 1.020，95% CI 1.002-1.039，p = 0.031），诊断受试者工作特征（ROC）曲线的曲线下面积（AUC）为0.878。OPN水平与血浆肌酐呈正相关（r = 0.401，p = 0.0001），但这种关系不能用急性肾损伤（阿基）的发展来解释，因为阿基和非AKI患者之间的OPN浓度没有差异。30天死亡率分析显示，存活和死亡患者之间的OPN水平无显著差异（p = 0.482）。总之，OPN浓度的单一测定有助于鉴别艾德中的脓毒症患者，但不能预测我们队列患者的不良预后。
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host-response to infections. Osteopontin (OPN) is an extracellular matrix protein involved in the inflammatory response. Our aim was to evaluate the diagnostic and prognostic performance in sepsis of a single OPN determination in the Emergency Department (ED). We conducted a single-centre prospective observational study in an Italian ED where we enrolled 102 consecutive patients presenting with suspected infection and qSOFA >= 2. OPN plasma concentration was found to be an independent predictor of sepsis (OR = 1.020, 95% CI 1.002-1.039, p = 0.031) and the diagnostic receiver operating characteristic (ROC) curve resulted in an area under the curve (AUC) of 0.878. OPN levels were positively correlated to plasma creatinine (r = 0.401 with p = 0.0001), but this relation was not explained by the development of acute kidney injury (AKI), since no difference was found in OPN concentration between AKI and non-AKI patients. The analysis of 30-days mortality showed no significant difference in OPN levels between alive and dead patients (p = 0.482). In conclusion, a single determination of OPN concentration helped to identify patients with sepsis in the ED, but it was not able to predict poor prognosis in our cohort of patients.