Abstract
Objective
In sepsis, dysregulation of the immune response leads to rapid multiorgan failure and death. Accurate and timely diagnosis is lifesaving and should discriminate sepsis from the systemic inflammatory response syndrome (SIRS) caused by non-infectious agents. Osteopontin acts as an extracellular matrix component or a soluble cytokine in inflamed tissues. Its exact role in immune response and sepsis remains to be elucidated. Therefore, we investigated the role of osteopontin in SIRS and sepsis.
Design
Prospective, observational study.
Setting
Intensive care unit of a university hospital.
Patients and participants
Fifty-six patients with SIRS or sepsis and 56 healthy subjects were enrolled.
Interventions
We analyzed the serum levels of osteopontin and TH1–TH2 cytokines and investigated the role of osteopontin on interleukin 6 secretion by monocytes.
Measurements and main results
Serum osteopontin levels were strikingly higher in patients than in controls and in sepsis than in SIRS, and decreased during the resolution of both the disorders. Receiver operating characteristic curves showed that osteopontin levels have discriminative power between SIRS and sepsis with an area under the curve of 0.796. Osteopontin levels directly correlated with those of interleukin 6 and in vitro, recombinant osteopontin increased interleukin 6 secretion by monocytes in both the absence and presence of high doses of lipopolysaccharide.
Conclusion
These data suggest that osteopontin might be a mediator involved in the pathogenesis of SIRS and sepsis, possibly by supporting interleukin 6 secretion.
Descriptor
45. SIRS/Sepsis: clinical studies.
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Acknowledgments
This work was partially supported by Telethon grant E1170 (Rome), AIRC (Milan), PRIN Project (MIUR, Rome), Compagnia di San Paolo (Turin), Regione Piemonte (Ricerca Sanitaria Finalizzata Project and Ricerca Sanitaria Applicata-CIPE Project), FISM 2005/R/10 (Genoa), Ricerca Corrente Ministeriale (Rome), Fondazione CARIPLO (Milan).
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This article is discussed in the editorial available at: doi:10.1007/s00134-008-1275-5.
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Vaschetto, R., Nicola, S., Olivieri, C. et al. Serum levels of osteopontin are increased in SIRS and sepsis. Intensive Care Med 34, 2176–2184 (2008). https://doi.org/10.1007/s00134-008-1268-4
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DOI: https://doi.org/10.1007/s00134-008-1268-4