Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis
Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis....
Gespeichert in:
| Veröffentlicht in: | PLoS neglected tropical diseases 2009-06, Vol.3 (6), p.e453-e453 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e453 |
|---|---|
| container_issue | 6 |
| container_start_page | e453 |
| container_title | PLoS neglected tropical diseases |
| container_volume | 3 |
| creator | Wagenaar, Jiri F P Gasem, M Hussein Goris, Marga G A Leeflang, Mariska Hartskeerl, Rudy A van der Poll, Tom van 't Veer, Cornelis van Gorp, Eric C M |
| description | Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.
In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.
Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe leptospirosis. |
| doi_str_mv | 10.1371/journal.pntd.0000453 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_plos_</sourceid><recordid>TN_cdi_plos_journals_1288100148</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_c75a9851a6fb45b083ce6d0b40ce824c</doaj_id><sourcerecordid>733219262</sourcerecordid><originalsourceid>FETCH-LOGICAL-c525t-27b9a568956b3807822d2f9087b677891e158d0f2c087333d4cc5d8c76e3f3943</originalsourceid><addsrcrecordid>eNptUk1v1DAUjBCIlsI_QBCJA6dd_BnbFyRUUai0Eoe2Z8uxX7ZeeeNgO0X8e7zdAC3CF1vvzYzfPE3TvMZojanAH3ZxTqMJ62ksbo3qYZw-aU6xonxFBOVPH7xPmhc57xDiikv8vDnBiknJkDhtbq5imPsA7dU1aQPcQcitSdCanKP1poBrf_hy21YIOD9uWz-2kykexpKPnVxJlbCBqcQ8-RSzzy-bZ4MJGV4t91lzc_H5-vzravPty-X5p83KcsJLHa1XhndS8a6nEglJiCODQlL0nRBSYcBcOjQQW0uUUses5U5a0QEdqGL0rHl71J1CzHrZSNaYSIkRwkxWxOUR4aLZ6Sn5vUk_dTRe3xdi2mqTircBtBXcKMmx6Yae8R5JaqFzqGfIgiTMVq2Py29zvwdn6w6SCY9EH3dGf6u38U6TTjIuD-O-XwRS_D5DLnrvs4UQzAhxzrp6JFiRjlTku3-Q_zfHjihbt54TDH9mwUgfQvKbpQ8h0UtIKu3NQx9_SUsq6C-QdLox</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1288100148</pqid></control><display><type>article</type><title>Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central Open Access</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Wagenaar, Jiri F P ; Gasem, M Hussein ; Goris, Marga G A ; Leeflang, Mariska ; Hartskeerl, Rudy A ; van der Poll, Tom ; van 't Veer, Cornelis ; van Gorp, Eric C M</creator><contributor>Peacock, Sharon J.</contributor><creatorcontrib>Wagenaar, Jiri F P ; Gasem, M Hussein ; Goris, Marga G A ; Leeflang, Mariska ; Hartskeerl, Rudy A ; van der Poll, Tom ; van 't Veer, Cornelis ; van Gorp, Eric C M ; Peacock, Sharon J.</creatorcontrib><description>Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.
In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.
Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe leptospirosis.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0000453</identifier><identifier>PMID: 19488407</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Critical Care and Emergency Medicine/Sepsis and Multiple Organ Failure ; Cytokines ; Cytokines - blood ; Female ; Hemorrhage - parasitology ; Humans ; Immune system ; Immunology ; Immunology/Immune Response ; Immunology/Innate Immunity ; Infectious Diseases ; Infectious Diseases/Bacterial Infections ; Infectious Diseases/Neglected Tropical Diseases ; Infectious Diseases/Tropical and Travel-Associated Diseases ; Interleukin-1 Receptor-Like 1 Protein ; Leptospirosis - complications ; Leptospirosis - mortality ; Leptospirosis - pathology ; Male ; Medical research ; Middle Aged ; Mortality ; Receptors, Cell Surface - blood ; Severity of Illness Index ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2009-06, Vol.3 (6), p.e453-e453</ispartof><rights>2009 Wagenaar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Wagenaar JFP, Gasem MH, Goris MGA, Leeflang M, Hartskeerl RA, et al. (2009) Soluble ST2 Levels Are Associated with Bleeding in Patients with Severe Leptospirosis. PLoS Negl Trop Dis 3(6): e453. doi:10.1371/journal.pntd.0000453</rights><rights>Wagenaar et al. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-27b9a568956b3807822d2f9087b677891e158d0f2c087333d4cc5d8c76e3f3943</citedby><cites>FETCH-LOGICAL-c525t-27b9a568956b3807822d2f9087b677891e158d0f2c087333d4cc5d8c76e3f3943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684584/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684584/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19488407$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Peacock, Sharon J.</contributor><creatorcontrib>Wagenaar, Jiri F P</creatorcontrib><creatorcontrib>Gasem, M Hussein</creatorcontrib><creatorcontrib>Goris, Marga G A</creatorcontrib><creatorcontrib>Leeflang, Mariska</creatorcontrib><creatorcontrib>Hartskeerl, Rudy A</creatorcontrib><creatorcontrib>van der Poll, Tom</creatorcontrib><creatorcontrib>van 't Veer, Cornelis</creatorcontrib><creatorcontrib>van Gorp, Eric C M</creatorcontrib><title>Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.
In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.
Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe leptospirosis.</description><subject>Adult</subject><subject>Critical Care and Emergency Medicine/Sepsis and Multiple Organ Failure</subject><subject>Cytokines</subject><subject>Cytokines - blood</subject><subject>Female</subject><subject>Hemorrhage - parasitology</subject><subject>Humans</subject><subject>Immune system</subject><subject>Immunology</subject><subject>Immunology/Immune Response</subject><subject>Immunology/Innate Immunity</subject><subject>Infectious Diseases</subject><subject>Infectious Diseases/Bacterial Infections</subject><subject>Infectious Diseases/Neglected Tropical Diseases</subject><subject>Infectious Diseases/Tropical and Travel-Associated Diseases</subject><subject>Interleukin-1 Receptor-Like 1 Protein</subject><subject>Leptospirosis - complications</subject><subject>Leptospirosis - mortality</subject><subject>Leptospirosis - pathology</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Receptors, Cell Surface - blood</subject><subject>Severity of Illness Index</subject><subject>Tropical diseases</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAUjBCIlsI_QBCJA6dd_BnbFyRUUai0Eoe2Z8uxX7ZeeeNgO0X8e7zdAC3CF1vvzYzfPE3TvMZojanAH3ZxTqMJ62ksbo3qYZw-aU6xonxFBOVPH7xPmhc57xDiikv8vDnBiknJkDhtbq5imPsA7dU1aQPcQcitSdCanKP1poBrf_hy21YIOD9uWz-2kykexpKPnVxJlbCBqcQ8-RSzzy-bZ4MJGV4t91lzc_H5-vzravPty-X5p83KcsJLHa1XhndS8a6nEglJiCODQlL0nRBSYcBcOjQQW0uUUses5U5a0QEdqGL0rHl71J1CzHrZSNaYSIkRwkxWxOUR4aLZ6Sn5vUk_dTRe3xdi2mqTircBtBXcKMmx6Yae8R5JaqFzqGfIgiTMVq2Py29zvwdn6w6SCY9EH3dGf6u38U6TTjIuD-O-XwRS_D5DLnrvs4UQzAhxzrp6JFiRjlTku3-Q_zfHjihbt54TDH9mwUgfQvKbpQ8h0UtIKu3NQx9_SUsq6C-QdLox</recordid><startdate>20090602</startdate><enddate>20090602</enddate><creator>Wagenaar, Jiri F P</creator><creator>Gasem, M Hussein</creator><creator>Goris, Marga G A</creator><creator>Leeflang, Mariska</creator><creator>Hartskeerl, Rudy A</creator><creator>van der Poll, Tom</creator><creator>van 't Veer, Cornelis</creator><creator>van Gorp, Eric C M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20090602</creationdate><title>Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis</title><author>Wagenaar, Jiri F P ; Gasem, M Hussein ; Goris, Marga G A ; Leeflang, Mariska ; Hartskeerl, Rudy A ; van der Poll, Tom ; van 't Veer, Cornelis ; van Gorp, Eric C M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-27b9a568956b3807822d2f9087b677891e158d0f2c087333d4cc5d8c76e3f3943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Critical Care and Emergency Medicine/Sepsis and Multiple Organ Failure</topic><topic>Cytokines</topic><topic>Cytokines - blood</topic><topic>Female</topic><topic>Hemorrhage - parasitology</topic><topic>Humans</topic><topic>Immune system</topic><topic>Immunology</topic><topic>Immunology/Immune Response</topic><topic>Immunology/Innate Immunity</topic><topic>Infectious Diseases</topic><topic>Infectious Diseases/Bacterial Infections</topic><topic>Infectious Diseases/Neglected Tropical Diseases</topic><topic>Infectious Diseases/Tropical and Travel-Associated Diseases</topic><topic>Interleukin-1 Receptor-Like 1 Protein</topic><topic>Leptospirosis - complications</topic><topic>Leptospirosis - mortality</topic><topic>Leptospirosis - pathology</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Receptors, Cell Surface - blood</topic><topic>Severity of Illness Index</topic><topic>Tropical diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wagenaar, Jiri F P</creatorcontrib><creatorcontrib>Gasem, M Hussein</creatorcontrib><creatorcontrib>Goris, Marga G A</creatorcontrib><creatorcontrib>Leeflang, Mariska</creatorcontrib><creatorcontrib>Hartskeerl, Rudy A</creatorcontrib><creatorcontrib>van der Poll, Tom</creatorcontrib><creatorcontrib>van 't Veer, Cornelis</creatorcontrib><creatorcontrib>van Gorp, Eric C M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wagenaar, Jiri F P</au><au>Gasem, M Hussein</au><au>Goris, Marga G A</au><au>Leeflang, Mariska</au><au>Hartskeerl, Rudy A</au><au>van der Poll, Tom</au><au>van 't Veer, Cornelis</au><au>van Gorp, Eric C M</au><au>Peacock, Sharon J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2009-06-02</date><risdate>2009</risdate><volume>3</volume><issue>6</issue><spage>e453</spage><epage>e453</epage><pages>e453-e453</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.
In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.
Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe leptospirosis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>19488407</pmid><doi>10.1371/journal.pntd.0000453</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2009-06, Vol.3 (6), p.e453-e453 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_1288100148 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Critical Care and Emergency Medicine/Sepsis and Multiple Organ Failure Cytokines Cytokines - blood Female Hemorrhage - parasitology Humans Immune system Immunology Immunology/Immune Response Immunology/Innate Immunity Infectious Diseases Infectious Diseases/Bacterial Infections Infectious Diseases/Neglected Tropical Diseases Infectious Diseases/Tropical and Travel-Associated Diseases Interleukin-1 Receptor-Like 1 Protein Leptospirosis - complications Leptospirosis - mortality Leptospirosis - pathology Male Medical research Middle Aged Mortality Receptors, Cell Surface - blood Severity of Illness Index Tropical diseases |
| title | Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T19%3A39%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Soluble%20ST2%20levels%20are%20associated%20with%20bleeding%20in%20patients%20with%20severe%20Leptospirosis&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Wagenaar,%20Jiri%20F%20P&rft.date=2009-06-02&rft.volume=3&rft.issue=6&rft.spage=e453&rft.epage=e453&rft.pages=e453-e453&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0000453&rft_dat=%3Cproquest_plos_%3E733219262%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1288100148&rft_id=info:pmid/19488407&rft_doaj_id=oai_doaj_org_article_c75a9851a6fb45b083ce6d0b40ce824c&rfr_iscdi=true |