Long pentraxin PTX3 is associated with mortality and disease severity in severe Leptospirosis

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• 作者：Jiri F.P. Wagenaar ; Marga G.A. Goris ; M. Hussein Gasem ; Bambang Isb ; rio ; Federica Moalli ; Alberto Mantovani ; Kimberly R. Boer ; Rudy A. Hartskeerl ; Cecilia Garl ; a ; Eric C.M. van Gorp
• 关键词：Leptospirosis ; Leptospira ; PTX3 protein ; Inflammation ; Sepsis ; Innate immunity
• 刊名：Journal of Infection
• 出版年：2009
• 出版时间：June 2009
• 年：2009
• 卷：58
• 期：6
• 页码：425-432
• 全文大小：368 K

文摘

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

<p>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

<p>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

<p>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.