• Ashley DeCoux, Yuan Tian, Kristine Y DeLeon-Pennell, Nguyen T Nguyen, Lisandra E de Castro Brás, Elizabeth R Flynn, Presley L Cannon, Michael E Griswold, Yu-Fang Jin, Michael A Puskarich, Alan E Jones, and Merry L Lindsey.
• 1San Antonio Cardiovascular Proteomics Center, San Antonio, TX. 2Mississippi Center for Heart Research, University of Mississippi Medical Center, Jackson, MS. 3Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS. 4Department of Electrical and Computer Engineering, University of Texas at San Antonio, San Antonio, TX. 5Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS. 6Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS. 7Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS.
• Crit. Care Med. 2015 Oct 1;43(10):2049-58.

ObjectiveSepsis remains a predominant cause of mortality in the ICU, yet strategies to increase survival have proved largely unsuccessful. This study aimed to identify proteins linked to sepsis outcomes using a glycoproteomic approach to target extracellular proteins that trigger downstream pathways and direct patient outcomes.DesignPlasma was obtained from the Lactate Assessment in the Treatment of Early Sepsis cohort. N-linked plasma glycopeptides were quantified by solid-phase extraction coupled with mass spectrometry. Glycopeptides were assigned to proteins using RefSeq (National Center of Biotechnology Information, Bethesda, MD) and visualized in a heat map. Protein differences were validated by immunoblotting, and proteins were mapped for biological processes using Database for Annotation, Visualization and Integrated Discovery (National Institute of Allergy and Infectious Diseases, National Institutes of Health; Bethesda, MD) and for functional pathways using Kyoto Encyclopedia of Genes and Genomes (Kanehisa Laboratories, Kyoto, Japan) databases.SettingHospitalized care.PatientsPatients admitted to the emergency department were enrolled in the study when the diagnosis of sepsis was made, within 6 hours of presentation.InterventionsNone.Measurements And Main ResultsA total of 501 glycopeptides corresponding to 234 proteins were identified. Of these, 66 glycopeptides were unique to the survivor group and corresponded to 54 proteins, 60 were unique to the nonsurvivor group and corresponded to 43 proteins, and 375 were common responses between groups and corresponded to 137 proteins. Immunoblotting showed that nonsurvivors had increased total kininogen; decreased total cathepsin-L1, vascular cell adhesion molecule, periostin, and neutrophil gelatinase-associated lipocalin; and a two-fold decrease in glycosylated clusterin (all p < 0.05). Kyoto Encyclopedia of Genes and Genomes analysis identified six enriched pathways. Interestingly, survivors relied on the extrinsic pathway of the complement and coagulation cascade, whereas nonsurvivors relied on the intrinsic pathway.ConclusionThis study identifies proteins linked to patient outcomes and provides insight into unexplored mechanisms that can be investigated for the identification of novel therapeutic targets.

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