Early depletion of contact system in patients with sepsis : a prospective matched control observational study
(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)
- author
- Berkestedt, Ingrid
LU
; Andersson, Pia
LU
; Herwald, Heiko
LU
; Valik, John Karlsson ; Sörensen, Ola and Bodelsson, Mikael LU
- organization
- publishing date
- 2018
- 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 < 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.</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}}, }