PURPOSE: Lysophosphatidylcholine(LPC) is a novel inflammatory lipid mediators, which has been suggested as additional regulator of immune response. Previous studies showed that LPC was significantly decreased in sepsis patients and might be an important biomarker to predict sepsis related mortality. However, previous LPC assay are complicated, time-consuming and limited in real clinical situation. So, we investigated serum LPC level in sepsis patients using enzymatic assay and analyzed correlations between serum concentration and clinical characteristics.
METHODS: We prospectively collected blood samples from patients who were suspected of sepsis on day 1 in Asan medical center during from September 2007 to November 2010. All blood samples were immediately centrifuged and serum was stored at -80°C within 2 hour after blood drawing. We analyzed all blood samples using ANZWELL LPC Assay Kit (Alfresa Pharma Corporation, Japan) which is an commercial enzymatic assay kit. Additionally, we analyzed serum LPC concentration of the control group which consisted of 21 healthy blood donors.
RESULTS: One hundred five patients, who fulfilled the criteria of sepsis through retrospective review of medical record, were included in this study. The mean serum LPC concentrations were 43.49 ± 33.09 umol/L in sepsis patients and lower than those of 21 healthy controls(234.68 ± 30.33 umol/L, P <0.001). Bacteremic sepsis showed lower level of serum LPC concentration than that of non-bacteremic group (34.81 ± 26.85 vs. 49.05 ± 35.63 umol/L, p<0.05). Between survivors and non-survivors, there is no difference in serum LPC concentration( 43.18 ± 28.82 vs 44.51 ± 8.96 umol/L, p=0.861). Although serum LPC concentration showed trends to decrease with severity, it did not showed statistically significant difference among subgroup(53.73 ± 34.93 vs 47.51 ± 41.33 vs 36.06 ± 19.56, p=0.063).
CONCLUSIONS: Day 1 Serum LPC concentration was decreased in patients with sepsis, especially in presence of bacteremia. However, serum LPC level does not correlate with severity and predict mortality of sepsis.
CLINICAL IMPLICATIONS: Our data suggests that serum LPC concentration is decreased in sepsis patients, especially in case of bacteremic sepsis. Enzymatic LPC assay may be useful and convenient method to study LPC, which is one of potential biomarker of sepsis
DISCLOSURE: The following authors have nothing to disclose: Woo Hyun Cho, Sang-Bum Hong, Jin Won Huh, Chae-Man Lim Lim, Younsuck Koh
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