• Daniel A Klaus, Rudolf Seemann, Franziska Roth-Walter, Elisa Einwallner, Michael C Motal, Bianca Tudor, Diana Lebherz-Eichinger, Marion Wiegele, Claus G Krenn, and Georg A Roth.
• From the Department of Anaesthesiology, General Intensive Care and Pain Medicine (DAK, MCM, BT, DLE, MW, CGK, GAR); RAIC Laboratory 13C1 (DAK, MCM, BT, DLE, MW, CGK, GAR); Department of Craniomaxillofacial and Oral Surgery (RS); Comparative Medicine Unit, Messerli Research Institute, University of Veterinary Medicine Vienna, and University of Vienna (FRW); and Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria (EE).
• Eur J Anaesthesiol. 2016 May 1; 33 (5): 348-55.

BackgroundChemokine ligand 20 (CCL20) is a chemokine released by mainly liver and blood leucocytes. Particularly under pro-inflammatory circumstances it triggers chemotaxis of lymphocytes and dendritic cells via activating receptor chemokine receptor 6 (CCR6) that is specific to it. In experimental sepsis models, the chemokine-receptor pair has been identified as a potential pathophysiological axis affecting mortality.ObjectiveMeasurement of CCL20 and CCR6 plasma levels in septic patients compared with postsurgical, nonseptic patients.DesignCase control study.SettingSurgical ICUs of the Department of Anaesthesiology, General Hospital of Vienna, Vienna, Austria.PatientsPlasma levels were measured in 46 patients with sepsis, severe sepsis or septic shock according to current American College of Chest Physicians/Society of Critical Care Medicine criteria at the day of sepsis onset. Plasma levels in 36 postsurgical controls without sepsis admitted to the ICU were investigated. Plasma concentrations were determined by using commercially available ELISA kits. Data are given as median and interquartile range (IQR).Main Outcome MeasuresCCL20 and CCR6 plasma levels.ResultsCCL20 plasma levels were significantly increased in the sepsis group: 220.9 pg ml (IQR, 72.8 to 540.1) compared with the ICU controls: 37.0 pg ml (IQR 6.5 to 83.6) (P < 0.0001). Significantly elevated CCR6 levels were found in the sepsis group: 2.47 ng ml (IQR 0.92 to 5.54) compared with the controls: 0.59 ng ml (IQR 0.17 to 1.48) (P < 0.0001). Both CCL20 and CCR6 correlated with the maximum sequential organ failure assessment score (CCL20: P < 0.0001, CCR6: P < 0.0001). Length of ICU admission depended significantly on the logarithm of CCR6 (P = 0.008) and sequential organ failure assessment maximum (P < 0.0001).ConclusionThere were early increased plasma concentrations of CCL20 and CCR6 in patients with sepsis. CCL20 and CCR6 correlate with severity of illness in ICU patients. Levels of CCR6 predicted the length of patients' admission.

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