Antibody against low density lipoproteins (oLAb), procalcitonin and neopterin as prognostic marker during sepsis and systemic inflammatory response syndrome (SIRS)

Introduction Aim of this study was to evaluate the impact of lipid peroxidation during the course of Sepsis and SIRS in ICU patients. As a biomarker for lipid peroxidation we used antibodies against oxidized LDL (oLAb). Furthermore, we applied Procalcitonin (PCT) and C-reactive protein (CRP) as markers for inflammation as well as Neopterin (NPT) as a marker for macrophage activation. oLAb play an important role in diseases associated with lipid peroxidation, e.g. liver disease, autoimmunological diseases, adipositas, heart and circulatory failure as well as infectious diseases like sepsis or SIRS. The hypothesis concerning the prognostic value of oLAb in sepsis indicates that increasing titers seem to be wholesome in contrast to decreasing values, which seem to show overwhelming lipidperoxidation. Patients and Methods 25 patients with verified sepsis (n=13; 7 survivor, 6 non-survivor) and SIRS (n=12; 7 survivor, 5 non-survivor). Patients stayed 48 hours at the ICU under the criteria according to Roger C. BONE and Jukka TAKALA. Biomarkers were determined every day, as clinic score we used APACHE II Score during the first 24 hours. In addition, we determined Cytokines (i.e. IL-1, IL6 and IL-8). Results Surviving patients showed significant increasing oLAb titres (p Conclusion Even though the number of patients was rather small we conclude that oLAb seems to be an indicative parameter for the follow up of sepsis and SIRS besides general inflammatory markers like CRP, PCT and NPT. Beyond that, the use of antioxidant drugs like Pentoxifylin, Ascorbic acid, Selenium, Alpha-Tocopherol as well as Coenzyme Q10, Allopurinol and N-Acetyl-cystein might be useful to reduce lipid peroxidation and to improve the chance to survive. Patients receiving parenteral or enteral nutrition or via infusion of those substances would show a better outcome.