000063289 001__ 63289
000063289 005__ 20171129112116.0
000063289 0247_ $$2doi$$a10.1371/journal.pone.0109618
000063289 0248_ $$2sideral$$a100167
000063289 037__ $$aART-2014-100167
000063289 041__ $$aeng
000063289 100__ $$aLorente, L.
000063289 245__ $$aSerum levels of caspase-cleaved cytokeratin-18 and mortality are associated in severe septic patients: Pilot study
000063289 260__ $$c2014
000063289 5060_ $$aAccess copy available to the general public$$fUnrestricted
000063289 5203_ $$aObjective: Apoptosis is increased in sepsis. Cytokeratin 18 (CK-18), a protein of the intermediate filament group present in most epithelial and parenchymal cells, is cleaved by the action of caspases and released into the blood as caspase-cleaved CK (CCCK)-18 during apoptosis. Circulating levels of CCCK-18 have scarcely been explored in septic patients. In one study with 101 severe septic patients, the authors reported higher serum CCCK-18 levels in non-survivors than in survivors; however, the sample size was too small to demonstrate an association between serum CCCK-18 levels and early mortality and whether they could be used as a biomarker to predict outcomes in septic patients. Thus, these were the objectives of this study with a large series of patients. Methods: We performed a prospective, multicenter, observational study in six Spanish Intensive Care Units with 224 severe septic patients. Blood samples were collected at the time that severe sepsis was diagnosed to determine serum levels of CCCK-18, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6 and IL-10. The end point was 30-day mortality. Results: Non-surviving patients (n = 80) showed higher serum CCCK-18 levels (P391 u/L were associated with 30-day survival (Odds ratio = 2.687; 95% confidence interval = 1.449-4.983; P = 0.002), controlling for SOFA score, serum lactic acid levels and age. Kaplan-Meier survival analysis showed that the risk of death in septic patients with serum CCCK-18 levels >391 u/L was higher than in patients with lower values (Hazard Ratio = 3.1; 95% CI = 1.96-4.84; P<0.001). Serum CCCK-18 levels were positively associated with serum levels of IL-6 and lactic acid, and with SOFA and APACHE scores. Conclusions: The major novel finding of our study, the largest cohort of septic patients providing data on circulating CCCK-18 levels, was that serum CCCK-18 levels are associated with mortality in severe septic patients.
000063289 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI10-01572$$9info:eu-repo/grantAgreement/ES/ISCIII/I3SNS-INT-11-063$$9info:eu-repo/grantAgreement/ES/ISCIII/I3SNS-INT-12-087
000063289 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000063289 590__ $$a3.234$$b2014
000063289 591__ $$aMULTIDISCIPLINARY SCIENCES$$b9 / 57 = 0.158$$c2014$$dQ1$$eT1
000063289 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000063289 700__ $$aMartín, M. M.
000063289 700__ $$aGonzález-Rivero, A. F.
000063289 700__ $$aFerreres, J.
000063289 700__ $$aSolé-Violán, J.
000063289 700__ $$0(orcid)0000-0002-3312-9383$$aLabarta, L.$$uUniversidad de Zaragoza
000063289 700__ $$aDíaz, C.
000063289 700__ $$aJiménez, A.
000063289 700__ $$aBorreguero-León, J. M.
000063289 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDepartamento de Medicina, Psiquiatría y Dermatología$$cMedicina
000063289 773__ $$g9, 10 (2014), e109618 [6 pp]$$pPLoS One$$tPLoS One$$x1932-6203
000063289 8564_ $$s177824$$uhttps://zaguan.unizar.es/record/63289/files/texto_completo.pdf$$yVersión publicada
000063289 8564_ $$s121902$$uhttps://zaguan.unizar.es/record/63289/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000063289 909CO $$ooai:zaguan.unizar.es:63289$$particulos$$pdriver
000063289 951__ $$a2017-11-28-12:45:36
000063289 980__ $$aARTICLE