Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Early depletion of contact system in patients with sepsis : a prospective matched control observational study

Berkestedt, Ingrid LU ; Andersson, Pia LU ; Herwald, Heiko LU orcid ; Valik, John Karlsson ; Sörensen, Ola and Bodelsson, Mikael LU (2018) In APMIS p.892-898
Abstract

Activation of the contact system generates bradykinin from high-molecular-weight kininogen and has been suggested to participate in the pathophysiology of sepsis. To test this, we prospectively measured bradykinin and high-molecular-weight kininogen levels in a cohort of sepsis patients requiring intensive care. From 29 patients meeting criteria for sepsis or septic shock according to Sepsis-3, blood was sampled within 24 h and on the fourth day following admittance to intensive care. Patients planned for neurosurgery served as matched controls. Sequential organ failure assessment score and 90-day mortality was registered. Bradykinin levels (median [interquartile range]) were lower in sepsis patients (79 [62–172] pg/ml) compared to... (More)

Activation of the contact system generates bradykinin from high-molecular-weight kininogen and has been suggested to participate in the pathophysiology of sepsis. To test this, we prospectively measured bradykinin and high-molecular-weight kininogen levels in a cohort of sepsis patients requiring intensive care. From 29 patients meeting criteria for sepsis or septic shock according to Sepsis-3, blood was sampled within 24 h and on the fourth day following admittance to intensive care. Patients planned for neurosurgery served as matched controls. Sequential organ failure assessment score and 90-day mortality was registered. Bradykinin levels (median [interquartile range]) were lower in sepsis patients (79 [62–172] pg/ml) compared to controls (130 [86–255] pg/ml, p < 0.025) and did not correlate with mortality or severity of circulatory derangement. High-molecular-weight kininogen levels were lower in sepsis patients (1.6 [0.8–4.8] densitometry units) compared to controls (4.4 [2.9–7.7] densitometry units, p < 0.001), suggesting previous contact system activation. High-molecular-weight kininogen levels were lower in non-survivors than survivors (p = 0.003) and negatively correlated to severity of circulatory derangement. We conclude that a role for bradykinin in later stages of severe sepsis must be challenged. Low high-molecular-weight kininogen concentrations suggest that the decrease in bradykinin is due to substrate depletion.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bradykinin, contact system, high-molecular-weight, kininogen, sepsis
in
APMIS
pages
892 - 898
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:30397964
  • scopus:85056146994
ISSN
0903-4641
DOI
10.1111/apm.12898
language
English
LU publication?
yes
id
0dccf2e2-92e5-4a68-b0ce-1bd366760b7e
date added to LUP
2018-11-23 09:20:48
date last changed
2024-05-13 20:27:21
@article{0dccf2e2-92e5-4a68-b0ce-1bd366760b7e,
  abstract     = {{<p>Activation of the contact system generates bradykinin from high-molecular-weight kininogen and has been suggested to participate in the pathophysiology of sepsis. To test this, we prospectively measured bradykinin and high-molecular-weight kininogen levels in a cohort of sepsis patients requiring intensive care. From 29 patients meeting criteria for sepsis or septic shock according to Sepsis-3, blood was sampled within 24 h and on the fourth day following admittance to intensive care. Patients planned for neurosurgery served as matched controls. Sequential organ failure assessment score and 90-day mortality was registered. Bradykinin levels (median [interquartile range]) were lower in sepsis patients (79 [62–172] pg/ml) compared to controls (130 [86–255] pg/ml, p &lt; 0.025) and did not correlate with mortality or severity of circulatory derangement. High-molecular-weight kininogen levels were lower in sepsis patients (1.6 [0.8–4.8] densitometry units) compared to controls (4.4 [2.9–7.7] densitometry units, p &lt; 0.001), suggesting previous contact system activation. High-molecular-weight kininogen levels were lower in non-survivors than survivors (p = 0.003) and negatively correlated to severity of circulatory derangement. We conclude that a role for bradykinin in later stages of severe sepsis must be challenged. Low high-molecular-weight kininogen concentrations suggest that the decrease in bradykinin is due to substrate depletion.</p>}},
  author       = {{Berkestedt, Ingrid and Andersson, Pia and Herwald, Heiko and Valik, John Karlsson and Sörensen, Ola and Bodelsson, Mikael}},
  issn         = {{0903-4641}},
  keywords     = {{Bradykinin; contact system; high-molecular-weight; kininogen; sepsis}},
  language     = {{eng}},
  pages        = {{892--898}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{APMIS}},
  title        = {{Early depletion of contact system in patients with sepsis : a prospective matched control observational study}},
  url          = {{http://dx.doi.org/10.1111/apm.12898}},
  doi          = {{10.1111/apm.12898}},
  year         = {{2018}},
}