Usefulness of heart-type fatty acid–binding protein in patients with severe sepsis

Zhang, Zhaocai; Dai, Hehua; Yu, Yihua; Yang, Jidong; Hu, Caibao

doi:10.1016/j.jcrc.2012.01.004

Cited by 36 publications

(34 citation statements)

References 27 publications

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“…Nevertheless, other FABPs in the serum are considered to be biochemical markers of tissue injury in related cells that produce FABP proteins: heart FABP for acute myocardial infarction, brain FABP for brain injury, intestinal FABP for intestinal damage [27,28]. In sepsis, elevated serum heart FABP and urinary liver FABP levels are believed to indicate myocardial and kidney injury as well [29,30]. Since the A-FABP level is higher in septic shock patients and positively correlated with lactic acid, the elevated A-FABP in critical illness might also reflect hypoperfusion and injuries to adipose tissues.…”

Section: Discussionmentioning

confidence: 99%

Serum adipocyte fatty acid-binding protein levels in patients with critical illness are associated with insulin resistance and predict mortality

Huang

Hsieh

et al. 2013

Crit Care

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IntroductionHyperglycemia and insulin resistance are commonplace in critical illness, especially in patients with sepsis. Recently, several hormones secreted by adipose tissue have been determined to be involved in overall insulin sensitivity in metabolic syndrome-related conditions, including adipocyte fatty-acid binding protein (A-FABP). However, little is known about their roles in critical illness. On the other hand, there is evidence that several adipose tissue gene expressions change in critically ill patients.MethodsA total of 120 patients (72 with sepsis, 48 without sepsis) were studied prospectively on admission to a medical ICU and compared with 45 healthy volunteers as controls. Various laboratory parameters and metabolic and inflammatory profiles were assessed within 48 hours after admission. Clinical data were collected from medical records.ResultsCompared with healthy controls, serum A-FABP concentrations were higher in all critically ill patients, and there was a trend of higher A-FABP in patients with sepsis. In multivariate correlation analysis in all critically ill patients, the serum A-FABP concentrations were independently related to serum creatinine, fasting plasma glucose, total cholesterol, TNF-alpha, albumin, and the Acute Physiology and Chronic Health Evaluation II scores. In survival analysis, higher A-FABP levels (> 40 ng/ml) were associated with an unfavorable overall survival outcome, especially in sepsis patients.ConclusionsCritically ill patients have higher serum A-FABP concentrations. Moreover, A-FABP may potentially serve as a prognostic biomarker in critically ill patients with sepsis.

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Section: Discussionmentioning

confidence: 99%

Serum adipocyte fatty acid-binding protein levels in patients with critical illness are associated with insulin resistance and predict mortality

Huang

Hsieh

et al. 2013

Crit Care

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“…Recent studies indicate, that hFABP can independently predict 28-d mortality and organ failure in patients with sepsis, severe sepsis or septic shock. Additionally, a correlation between plasma concentration and sepsis-induced myocardial dysfunction has been described and elevation of hFABP is associated with an increasing mortality rate [101][102][103] . hFABP may thus be a promising marker to identify high risk patients in the emergency department.…”

Section: Heart Type Fatty Acid Binding Proteinmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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“…Septic patients with elevated cTn levels can have a 2–5 fold increased risk of death, even in the absence of known cardiovascular disease (Mantzouris et al, 2013). Another serum cardiac marker used in sepsis disease is Creatine Kinase (CK) which its high level is associated with higher mortality rate (Oliveira et al, 2008; Zhang et al, 2012). This biochemical parameter improved after different treatment approaches in murine (He et al, 2014; Smith et al, 2016; Zhang et al, 2015) and human (Hua et al, 2012; Zhang et al, 2012) sepsis.…”

Section: Non-invasive Methods To Assess Heart Function In Sepsismentioning

confidence: 99%

Complement and sepsis-induced heart dysfunction

Fattahi

Ward

2017

Molecular Immunology

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It is well known that cardiac dysfunction develops during sepsis in both humans and in rodents (rats, mice). These defects appear to be reversible, since after “recovery” from sepsis, cardiac dysfunction disappears and the heart returns to its function that was present before the onset of sepsis. Our studies, using in vivo and in vitro models, have demonstrated that C5a and its receptors (C5aR1 and C5aR2) play key roles in cardiac dysfunction developing during sepsis. Use of a neutralizing antibody to C5a largely attenuates cardiac dysfunction and other adverse events developing during sepsis. The molecular basis for cardiac dysfunctions is linked to generation of C5a and its interaction with C5a receptors present on surfaces of cardiomyocytes (CMs). It is established that C5a interactions with C5a receptors leads to significant reductions involving faulty contractility and relaxation in CMs. In addition, C5a interactions with C5a receptors or CMs results in reductions in Na+/K+-ATPase in CMs. This ATPase is essential for intact action potentials in CMs. The enzymatic activity and protein for this ATPase were strikingly reduced in CMs during sepsis by unknown mechanisms. In addition, C5a interactions with C5aRs also caused reductions in CM homeostatic proteins that regulate cytosolic [Ca2+]i in CMs: sarco/endoplasmic reticulum Ca2+-ATPase (SERCA2) and Na+/Ca2+ exchanger (NCX). In the absence of C5a receptors, defects in SERCA2 and NCX in CMs after sepsis are strikingly attenuated. These observations suggest new strategies to protect the heart from dysfunction developing during sepsis.

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Usefulness of heart-type fatty acid–binding protein in patients with severe sepsis

Cited by 36 publications

References 27 publications

Serum adipocyte fatty acid-binding protein levels in patients with critical illness are associated with insulin resistance and predict mortality

Serum adipocyte fatty acid-binding protein levels in patients with critical illness are associated with insulin resistance and predict mortality

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Complement and sepsis-induced heart dysfunction

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