Long pentraxin PTX3 is associated with mortality and disease severity in severe Leptospirosis - 07/08/11
, Marga G.A. Goris b, h , M. Hussein Gasem c, i , Bambang Isbandrio d, j , Federica Moalli e, k , Alberto Mantovani e, f, k, l , Kimberly R. Boer b, h, Rudy A. Hartskeerl b, h , Cecilia Garlanda e, k , Eric C.M. van Gorp a, g
Corresponding author. Tel.: +31 20 5129333; fax: +31 20 5124783.Summary |
Objective |
To evaluate the long pentraxin PTX3 in patients with severe leptospirosis and to compare the results with the widely used short pentraxin C-reactive protein and the pro-inflammatory cytokines IL-6 and IL-8.
Methods |
This observational cohort study was carried out in Semarang, Indonesia, where leptospirosis is endemic and mortality is high. Consecutive patients with severe leptospirosis were sampled on admission and during follow-up.
Results |
A total number of 52 patients entered the study, the mortality was 27%. Severe leptospirosis patient yielded elevated plasma PTX3 levels. PTX3 correlated with IL-8 and to a lesser extent with CRP and IL-6 levels. High levels of PTX3, IL-6 and IL-8 were associated with mortality (OR 5.6, 95%CI: 1.2–26; OR 3.2, 95%CI: 1.2–8.1; OR 6.5, 95%CI: 1.5–28). Moreover, PTX3 levels were associated with disease severity (OR 9.5; 95%CI: 2.9–45). This association was unique, since none of the other markers showed this relation. C-reactive protein was not able to differentiate the severe from the severest cases.
Conclusions |
The long pentraxin PTX3 is elevated in patients with severe leptospirosis and is associated with fatal disease and disease severity. PTX3 may be used as a marker to monitor disease severity in severe leptospirosis or predict outcome.
Le texte complet de cet article est disponible en PDF.Keywords : Leptospirosis, Leptospira, PTX3 protein, Inflammation, Sepsis, Innate immunity
Plan
Vol 58 - N° 6
P. 425-432 - juin 2009 Retour au numéro
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