| Background:Sepsis is one of the major causes of death among hospitalized patients worldwide.Its pathological process is complex,involving various aspects such as inflammation,immunity and coagulation,Due to the lack of effective targeted therapies,life support intervention in ICU is a regular treatment of sepsis.The early diagnosis of sepsis can guide the early onset of appropriate care for patients and improve survival.In the past(1992-2016),sepsis was defined as systemic inflammatory response syndrome(SIRS)caused by infection.The corresponding diagnostic criteria was focused on the detection of inflammatory markers.In 2016,the definition of sepsis was modified as a life-threatening organ dysfunction caused by a dysregulated host response to infection.Organ dysfunction is determined by multiple system function scores(SOFA).Despite a lot of efforts,the exact pathogenesis of sepsis remains unknown,and there is not any diagnostic gold standard for sepsis.Because the positive rate of bacterial culture is very low,the diagnosis of sepsis largely depends on the doctor's clinical experience and inflammation index changes.Therefore,we need to find better early biomarkers for sepsis.Currently,there are more than 200 biomarkers for diagnosis of sepsis,such as C-reactive protein and procalcitonin.However,these markers lack high sensitivity,specificity or have other deficiencies that are not suitable for early diagnosis of sepsis.In the previous work,we found that plasma tetranectin(TTN)of sepsis patients is significantly lower than that of healthy ones.Because TTN level in plasma may vary with different physical conditions,the diagnostic role of TTN in sepsis is unclear.Therefore,our study detected the level of TTN and TTN subtypes in pneumonia,burn patients and related sepsis,to explore the diagnostic role of them in sepsis.Methods:According to the Sepsis-3 criteria,patients with pneumonia-associated sepsis and patients with burn sepsis were enrolled from September 2016 to September 2017 in the ICU of Huaihe Hospital of Henan University.At the same time,pneumonia patients,burn patients and healthy people were enrolled.Analysis of plasma TTN in these people was performed by Western-Blot as well as two dimensional electrophoresis.Results:By Western-Blot method we found:1.TTN level in the plasma of pneumonia patients is significantly lower than that of healthy people(p < 0.001).2.TTN level in the plasma of patients with pneumonia-associated sepsis is significantly lower than that of pneumonia patients(p < 0.05).3.TTN level in the plasma of burn patients with sepsis is significantly lower than that of burn patients without sepsis(p < 0.05).4.There is no significant difference in hydrophobic properties of plasma TTN in healthy people and pneumonia patients(p=0.61)5.The hydrophobic properties of plasma TTN in patients with pneumonia-associated sepsis is significantly lower than that in pneumonia patients and healthy people.(p = 0.00004 vs normal,p = 0.002 vs pneumonia),which demonstrates that the post-modification of plasma TTN in sepsis patients is different from that in pneumonia patients and healthy people.By two dimensional electrophoresis we found:1.There are at least four isoforms of TTN in human plasma(TN1,TN2,TN3,TN4),which demonstrates there are various post-modifications of plasma TTN.2.The percentage of different TTN isoform in total plasma TTN is different between pneumonia patients and patients with pneumonia-associated sepsis,and the percentage of TN2 in total plasma TTN in patients with pneumonia-associated sepsis is significantly higher than that of patients with pneumonia(p < 0.05).Conclusion:TTN level in the plasma of pneumonia patients is significantly lower than that of healthy people.TTN level in the plasma of patients with pneumonia-associated sepsis is lower than that of pneumonia patients,and TTN level in the plasma of burn patients with sepsis is significantly lower than that of burn patients without sepsis.There are at least four isoforms of TTN in human plasma,and the percentage of TN2 in total plasma TTN in patients with pneumonia-associated sepsis is significantly higher than that of pneumonia patients..This study suggests that the detection of total plasma TTN and its isoforms has potential application value in the diagnosis of sepsis. |
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