• Athina Savva, Maria Raftogiannis, Fotini Baziaka, Christina Routsi, Anastasia Antonopoulou, Pantelis Koutoukas, Thomas Tsaganos, Anastasia Kotanidou, Efterpi Apostolidou, Evangelos J Giamarellos-Bourboulis, and George Dimopoulos.
• 4th Department of Internal Medicine, ATTIKON University Hospital, 1 Rimini Str, 12462 Athens, Greece. savva.athina@gmail.com
• J. Infect. 2011 Nov 1;63(5):344-50.

AbstractUrokinase plasminogen activator (uPAR) is a receptor mainly expressed on peripheral blood mononuclear cells and neutrophils. The role of its soluble form, namely suPAR, as a predictor of sepsis outcome in a homogenous cohort of 180 septic patients, was investigated. Blood from 180 patients with ventilator-associated pneumonia (VAP) and sepsis was collected for seven consecutive days. suPAR and PCT were measured in serum by an enzyme immunoassay and an immuno-time-resolved amplified cryptate assay respectively. Neutrophils and monocytes were isolated on day 1 and incubated. suPAR levels greater than 10.5 ng/ml had 80% specificity and 77.6% positive predictive value to discriminate between severe sepsis and sepsis. suPAR levels greater than 12.9 ng/ml had 80% specificity and 76.1% positive predictive value for prognosis of unfavorable outcome. suPAR levels were significantly lower among survivors than among non-survivors over follow-up. Step-wise Cox regression analysis found suPAR as an independent factor related with unfavorable outcome (p: 0.026). Concentrations of suPAR in supernatants of neutrophils of patients with sepsis were greater compared to controls. It is concluded that suPAR is a reliable marker of sepsis severity and a strong independent predictor of unfavorable outcome in VAP and sepsis. Neutrophils are involved in release.Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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