A Study On The Time Course Of Plasma Gelsolin During Severe Sepsis

[Objective] To investigate plasma gelsolin levels in severe septic patients and to determine if these levels predict the severity or clinical outcome of severe sepsis. [Methods] Ninet y-one patients who were diagnosed severe sepsis at admission in a surgical intensive care unit (ICU) were enrolled with admission plasma gelsolin levels, of which 23 had daily plasma gelsolin levels. Fifteen non-septic critically ill patients were enrolled with daily plasma gelsolin levels. Fifteen volunteers served as healthy controls. Plasma gelsolin levels were measured using an enzyme-linked immunosorbent assay. [Results] The admission gelsolin levels were significantly decreased in severe sepsis (20.6±11.7 mg/L) compared to non-septic critically ill patients (52.3±20.3 mg/L, p<0.001) and healthy controls (126.8±32.0 mg/L, p<0.001). Survivors of severe sepsis had substantial recovery of their depressed plasma gelsolin levels, while the gelsolin levels in nonsurvivors remained at or below their depleted admission levels. Plasma gelsolin levels at the end-point in surviving patients with severe sepsis were significantly higher than those in non-surviving patients with severe sepsis (30.0±7.0mg/L vs. 15.0±4.6mg/L, p<0.001). [Conclusions] Plasma gelsolin may be a valuable marker for severe sepsis. Recovery of depleted plasma gelsolin levels correlated with clinical improvement. The prognostic role of plasma gelsolin in critical illness need to be further investigated in large cohort.