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Critical Care: Mechanisms of Infections |

Clinical and Experimental Significance of Vitamin D-Binding Protein in Patients With Sepsis and the Mouse Sepsis Model FREE TO VIEW

Duchao Zhang, PhD; Kun Xiao, MD; Wei Guan; LongXiang Su; Lixin Xie
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Chinese PLA General Hospital, Beijing, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A181. doi:10.1016/j.chest.2016.02.187
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SESSION TITLE: Mechanisms of Infections

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 04:00 PM - 05:00 PM

PURPOSE: In this study, we sought to determine the correlation between the degree of serum VDBP and progression of sepsis patients and mouse sepsis model.

METHODS: We performed a prospective study on 131 patients diagnosed with sepsis at different stages (sepsis group) and 25 patients with severe acute pancreatitis (control groups). A classic caecal ligation and puncture (CLP) in comparison with a sham procedure was used to establish experimental sepsis model in mice (n=40). Serum VDBP levels were assayed by ELISA. The pathologic changes were observed under electron microscope via HE stain. To measure the optical density of VDBP immunoreactivity, the region of interest in the lung, liver and spleen of mice were acquired.

RESULTS: Patients diagnosed with septic shock had significantly lower serum concentration of VDBP than the patients diagnosed with severe and moderate sepsis (p < 0.05). In addition, the serum levels of VDBP at the time of admission to the hospital were significantly lower in non-survivors than in the survivors (140.1±24.5mg/L vs. 170.3±25.4mg/L, p<0.001). In the mouse model, VDBP levels in CLP operated mice exhibited bimodal alterations, with a continuous and significant reduction in VDBP levels from day1 onwards (P< 0.001). This was followed by a progressive elevation reaching the initial concentrations at day 7 post CLP in survivors which displayed a negative relationship between serum VDBP and strength and duration of organ lesion. The immunohistochemical examination for VDBP indicated no reactivity in liver sections with tissue damage in the CLP group. However, VDBP immunoreactivity was observed in the infiltrating lymphocytes and multiple Kupffer cells and granuloma formation was also positive for the CLP group. The lung, blood, airway secretions, macrophages and granuloma were positive for VDBP in CLP mice. VDBP positive cell accumulation was observed in the splenic sinus of both the control mice and CLP treated mice. However, the number of cells positive for VDBP in the spleen was significantly higher in the CLP treated mice than in the control mice.

CONCLUSIONS: Serum VDBP level is negatively correlated with the development of sepsis and the degree of tissue damage. The serum levels of VDBP at the time of hospitalization of the patient could be used to make an early assessment of the prognosis of sepsis with potential clinical value.

CLINICAL IMPLICATIONS: The dynamic changes of VDBP serum levels can be used to monitor the progression of sepsis.

DISCLOSURE: The following authors have nothing to disclose: Duchao Zhang, Kun Xiao, Wei Guan, LongXiang Su, Lixin Xie

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