HOW CLOSELY IS PROTEIN CARBONYL (PCO) LEVEL CORRELATED WITH SEPSIS-RELATED ORGAN FUNCTION ASSESSMENT (SOFA) SCORE?

  • MAYANG INDAH LESTARI Staff Lecturer, Department of Anesthesia and Intensive Care, Faculty of Medicine, Universitas Sriwijaya–Mohammad Hoesin Hospital, Palembang, Indonesia, Trainee in Intensive Care Program, Faculty of Medicine, Universitas Indonesia–Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • RUDYANTO SEDONO Staff Lecturer, Department of Anesthesia and Intensive Care, Universitas Indonesia–Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • ZULKIFLI Staff Lecturer, Department of Anesthesia and Intensive Care, Faculty of Medicine, Universitas Sriwijaya–Mohammad Hoesin Hospital, Palembang, Indonesia
  • ZISKE MARITSKA Staff Lecturer, Department of Biology, Universitas Sriwijaya, Palembang, Indonesia

Abstract

Objective: Sepsis remains an unsolved problem in hospitals since its mortality rate is not significantly reduced despite considerable therapy efforts. The most used prognostic tool is the Sepsis-related Organ Function (SOFA) score, which requires several clinical and laboratory examinations; our recent studies also showed that the protein carbonyl level (PCO) has prognostic value in predicting sepsis mortality.


Methods: This prospective study was designed to assess the correlation between PCO values and the SOFA score following ethical approval. Adult patients aged>18 y who met the Sepsis-3 definition were included. Exclusion criteria were patients not admitted to the intensive care unit. Dropout criteria included mortality within the 1h bundle protocol. Baseline demographic data and blood collection were measured for all subjects. Subjects were treated with the 1h bundle protocol and observed for 28 d.


Results: Fifty-nine subjects were included, with no significant differences in age, sex, diagnosis, microbiology or Charlson’s Comorbidity score between survivors and non-survivors. The SOFA score was higher in non-survivors (10.90±3.38 vs 8.11±3.07; p=0.003), as was the PCO value (24.5 [14.67-81] vs 18 [15-21.33]; p<0.001). However, the correlation between PCO and SOFA score is very weak (r=0.101; p=0.45).


Conclusion: Both the PCO level and SOFA scores were higher in non-survivor septic patients. However, they have a very weak correlation and cannot be used interchangeably.

Keywords: Correlation, Mortality, Protein carbonyl, Sepsis, SOFA score

References

1. Website Centers for Disease Control and Prevention. Sepsis. Atlanta: Centers for Disease Control and Prevention Data and Reports; 2018. Available from https://www.cdc.gov/ sepsis/datareports/index.html [Last accessed on 2018]
2. Marshall JG, Vincent JL, Guyatt G, Angus DC, Abraham E, Bernard G, et al. Outcome measures for clinical research in sepsis: a report of the 2nd cambridge colloquium of the international sepsis forum. Crit Care Med 2005;33:1708–16.
3. Singer M, Deutschman CS, Seymour CW, Shankar Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). J Am Med Assoc 2016;315:801–10.
4. Mantzarlis K, Tsolaki V, Zakynthinos E. Role of oxidative stress and mitochondrial dysfunction in sepsis and potential therapies. Oxid Med Cell Longev 2017;1–10. DOI: 10.1155/2017/5985209
5. Weiss SL, Deutschman CS. Elevated malondialdehyde levels in sepsis-something to “stress” about? Crit Care 2014;18:1-2.
6. Galley HF. Oxidative stress and mitochondrial dysfunction in sepsis. Br J Anaesth 2011;107:57-64.
7. Singh Z, Karthigesu IP, Singh P, Kaur R. Use of malondialdehyde as a biomarker for assessing oxidative stress in different disease pathologies: a review. Iran J Public Health 2014;43:7–16.
8. Costa NA, Gut AL, Azevedo PS, Tanni SE, Cunha NB, Fernandes AAH, et al. Protein carbonyl concentration as a biomarker for development and mortality in sepsis-induced acute kidney injury. Biosci Rep 2018;38:1–8.
9. Abu-Zidan FM, Winterbourn CC, Bonham MJD, Simovic MO, Buss H, Windsor JA. Small bowel ischemia-reperfusion increases plasma concentrations of oxidized proteins in rats. Eur J Surg 1999;165:383–9.
10. Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle. Intensive Care Med 2018;44:1–4.
11. Medam S, Zieleskiewicz L, Duclos G, Baumstarck K, Loundou A, Alingrin J, et al. Risk factors for death in septic shock. Medicine (Baltimore) 2017;96:1–7.
12. Lie KC, Lau CY, Van Vinh Chau N, West TE, Limmathurotsakul D (Southeast Asia infectious disease clinical research network). Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: A multinational, multicenter prospective observational study. J Intensive Care 2018;6:1–8.
13. Bhattacharya S. Reactive oxygen species and cellular defense system. In: Rani V, Yadav UCS. editors. Free radicals in human health and disease. New Delhi: Springer; 2015. p. 17–29.
14. Dalle Donne I, Giustarini D, Colombo R, Rossi R, Milzani A. Protein carbonylation in human diseases. Trends Mol Med 2003;9:169–76.
15. Suzuki YJ, Carini M, Butterfield DA. Protein carbonylation. Antioxid Redox Signal 2010;12:323–5.
16. Barreiro E. Role of protein carbonylation in skeletal muscle mass loss associated with chronic conditions. Proteomes, 2016;4:1–23.
17. Abu Zidan FM, Plank LD, Windsor JA. Proteolysis in severe sepsis is related to oxidation of plasma protein. Eur J Surg 2002;168:119–23.
18. Costa NA, Gut AL, Azevedo PS, Fernandes AAH, Polegato BF, Cunha NB, et al. Protein carbonyl, but not malondialdehyde, is associated with ICU mortality in patients with septic shock. J Intensive Care Med 2017;20:1–5.
19. Andresen M, Regueira T, Bruhn A, Perez D, Strobel P, Dougnac A, et al. Lipoperoxidation and protein oxidative damage exhibit different kinetics during septic shock. Mediators Inflamm 2008;2008:168652.
Statistics
11 Views | 25 Downloads
Citatons
How to Cite
LESTARI, M. I., SEDONO, R., ZULKIFLI, & MARITSKA, Z. (2020). HOW CLOSELY IS PROTEIN CARBONYL (PCO) LEVEL CORRELATED WITH SEPSIS-RELATED ORGAN FUNCTION ASSESSMENT (SOFA) SCORE?. International Journal of Applied Pharmaceutics, 12(3), 79-82. https://doi.org/10.22159/ijap.2020.v12s3.39480
Section
Full Proceeding Paper