AI Article Synopsis

  • The study explored the levels of the protease inhibitor ITIH4 in sepsis patients compared to healthy individuals, aiming to understand its role in sepsis monitoring and prognosis.
  • ITIH4 levels did not significantly increase during septic shock, and though it varied widely among patients, low levels correlated with severe coagulopathy and other blood coagulation issues.
  • Overall, ITIH4 is linked to complications in sepsis but does not behave as an acute-phase marker during septic shock.

Article Abstract

Background: The protease inhibitor inter-α-inhibitor heavy chain H4 (ITIH4) has been described as an acute-phase reactant and could potentially aid in sepsis monitoring and prognostication.

Objectives: To investigate ITIH4 plasma levels in sepsis patients compared with healthy controls and to examine the association between ITIH4 and acute-phase response markers, blood coagulation, and organ dysfunction in sepsis.

Methods: We performed a post hoc study to a prospective cohort study. Patients with septic shock (n = 39) were enrolled upon intensive care unit admission. ITIH4 was analyzed using an in-house immunoassay. Standard coagulation parameters, thrombin generation, fibrin formation and lysis, C-reactive protein, organ dysfunction markers, Sequential Organ Failure Assessment score, and disseminated intravascular coagulation (DIC) score were registered. ITIH4 levels were also investigated in a murine sepsis model.

Results: ITIH4 did not display acute-phase behavior as mean ITIH4 levels were not increased in patients with septic shock or in -infected mice. However, ITIH4 exhibited large interindividual variation in patients with septic shock compared with healthy controls. Low ITIH4 was associated with sepsis-related coagulopathy, including a high DIC score (mean ITIH4: DIC, 203 μg/mL vs non-DIC, 267 μg/mL,  = .01), low antithrombin ( = 0.70,  < .0001) and decreased thrombin generation (mean ITIH4: first peak thrombin tertile, 210 μg/mL vs third peak thrombin tertile, 303 μg/mL,  = .01). ITIH4 showed moderate correlation with arterial blood lactate (ρ = -0.50,  < .001) but only weak correlations with C-reactive protein, alanine transaminase, bilirubin, and Sequential Organ Failure Assessment score (all, ρ < 0.26, > .05).

Conclusion: ITIH4 is associated with sepsis-related coagulopathy but is not an acute-phase reactant during septic shock.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9974438PMC
http://dx.doi.org/10.1016/j.rpth.2023.100078DOI Listing

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