• Nikhil Kothari, Ravi S Keshari, Jaishri Bogra, Monica Kohli, Haider Abbas, Anita Malik, Madhu Dikshit, and Manoj K Barthwal.
• Department of Anaesthesia, Chatrapati Shahuji Maharaj Medical University, Lucknow, UP, India. drnikhilkothari@rediffmail.com
• J Crit Care. 2011 Aug 1;26(4):435.e1-7.

IntroductionCirculating lipopolysaccharides released from bacteria may activate both neutrophils and monocytes. The activated neutrophils release myeloperoxidase (MPO), a specific enzyme with strong oxidative activity. The aim of this study was to evaluate MPO enzyme activity in plasma of critically ill patients and to check the hypothesis that these concentrations in plasma would be higher in sepsis and systemic inflammatory conditions, as neutrophils release their contents before proliferating in response to stress.Material And MethodsBlood samples were collected from 105 critically ill patients admitted to the intensive care unit, consisting of those with systemic inflammatory response syndrome (n = 42), sepsis (n = 37), and septic shock (n = 26). Plasma MPO enzyme activity was determined by o-dianisidine-H(2)O(2) method, modified for 96-well plates.ResultsThe plasma MPO enzyme activity in sepsis patients was significantly higher than that in the control group (mean, 2.4 ± 1.8 in sepsis and 1.86 ± 1.2 nmol per milligram protein per 10 minutes in systemic inflammatory response syndrome vs 0.32 ± 0.11 nmol per milligram protein per 10 minutes in healthy controls). Mean plasma lactate levels in sepsis (7.8 ± 1.2 mmol/L) and shock patients (9.5 ± 1.2 mmol/L) and cytokines like tumor necrosis factor-α, interleukin-8, and interleukin-1β were simultaneously evaluated to establish onset of inflammation and sepsis. These results show that neutrophil activation occurring during inflammation and sepsis could be detected by plasma MPO concentration.ConclusionThe plasma MPO concentrations may be a marker of the neutrophil proliferation and severity of inflammation.Copyright © 2011 Elsevier Inc. All rights reserved.

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