• Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, and Stylianos E Orfanos.
• First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Evangelismos Hospital, Medical School of the National and Kapodistrian University of Athens, Athens, Greece. alvass75@gmail.com.
• Infect Dis Ther. 2018 Mar 1; 7 (Suppl 1): 3-14.

IntroductionA soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients.MethodsThree polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU. Multivariate logistic regression analysis controlling for sepsis severity, age, acute physiology and chronic health evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores, lactate level, sex, diagnostic category, length of ICU stay and hospital mortality was performed to determine the effect of EPCR haplotypes H1 and H3 on the levels of sEPCR.ResultsIndividuals carrying at least one H3 allele had significantly higher levels of sEPCR than individuals with no H3 alleles (p < 0.001). No differences were found in the distribution of the H3 allele in the patient groups categorized using the pre-existing and current sepsis-3 definitions.ConclusionUsing the preceding and current sepsis definitions, sEPCR levels and the H3 haplotype were not associated with sepsis severity and the risk of poor outcomes in septic patients; however, the EPCR H3 allele contributed to higher levels of sEPCR.

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