Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis.
Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis....
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ftdoajarticles:oai:doaj.org/article:c75a9851a6fb45b083ce6d0b40ce824c 2023-05-15T15:14:43+02:00 Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. Jiri F P Wagenaar M Hussein Gasem Marga G A Goris Mariska Leeflang Rudy A Hartskeerl Tom van der Poll Cornelis van 't Veer Eric C M van Gorp 2009-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000453 https://doaj.org/article/c75a9851a6fb45b083ce6d0b40ce824c EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2684584?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000453 https://doaj.org/article/c75a9851a6fb45b083ce6d0b40ce824c PLoS Neglected Tropical Diseases, Vol 3, Iss 6, p e453 (2009) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2009 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000453 2022-12-31T15:58:41Z Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 3 6 e453 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Jiri F P Wagenaar M Hussein Gasem Marga G A Goris Mariska Leeflang Rudy A Hartskeerl Tom van der Poll Cornelis van 't Veer Eric C M van Gorp Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Severe leptospirosis features bleeding and multi-organ failure, leading to shock and death. Currently it is assumed that both exaggerated inflammation and immune suppression contribute to mortality in sepsis. Indeed, several proinflammatory cytokines are reported to be induced during leptospirosis. Toll-like receptors, which play an important role in the initiation of an innate immune response, are inhibited by negative regulators including the membrane-bound ST2 (mST2) receptor. Soluble ST2 (sST2) has been implicated to inhibit signaling through mST2. The aim of this study was to determine the extent of sST2 and (pro-) inflammatory cytokine release in patients with severe leptospirosis.In an observational study, 68 consecutive cases of severe leptospirosis were included. Soluble ST2 and cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10) were repeatedly measured. To determine whether blood cells are a source of sST2 during infection, we undertook an in vitro experiment: human whole blood and peripheral blood mononuclear cells (PBMC) were stimulated with viable pathogenic Leptospira. All patients showed elevated sST2, IL-6, IL-8, and IL-10 levels on admission. Admission sST2 levels correlated with IL-6, IL-8, and IL-10. Thirty-four patients (50%) showed clinical bleeding. Soluble ST2 levels were significantly associated with bleeding overall (OR 2.0; 95%CI: 1.2-3.6) and severe bleeding (OR 5.1; 95%CI: 1.1-23.8). This association was unique, since none of the cytokines showed this correlation. Moreover, sST2 was associated with mortality (OR 2.4; 95%CI: 1.0-5.8). When either whole blood or isolated PBMCs were stimulated with Leptospira in vitro, no sST2 production could be detected.Patients with severe leptospirosis demonstrated elevated plasma sST2 levels. Soluble ST2 levels were associated with bleeding and mortality. In vitro experiments showed that (white) blood cells are probably not the source. In this regard, sST2 could be an indicative marker for tissue damage in patients suffering from severe ... |
format |
Article in Journal/Newspaper |
author |
Jiri F P Wagenaar M Hussein Gasem Marga G A Goris Mariska Leeflang Rudy A Hartskeerl Tom van der Poll Cornelis van 't Veer Eric C M van Gorp |
author_facet |
Jiri F P Wagenaar M Hussein Gasem Marga G A Goris Mariska Leeflang Rudy A Hartskeerl Tom van der Poll Cornelis van 't Veer Eric C M van Gorp |
author_sort |
Jiri F P Wagenaar |
title |
Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
title_short |
Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
title_full |
Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
title_fullStr |
Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
title_full_unstemmed |
Soluble ST2 levels are associated with bleeding in patients with severe Leptospirosis. |
title_sort |
soluble st2 levels are associated with bleeding in patients with severe leptospirosis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2009 |
url |
https://doi.org/10.1371/journal.pntd.0000453 https://doaj.org/article/c75a9851a6fb45b083ce6d0b40ce824c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 3, Iss 6, p e453 (2009) |
op_relation |
http://europepmc.org/articles/PMC2684584?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000453 https://doaj.org/article/c75a9851a6fb45b083ce6d0b40ce824c |
op_doi |
https://doi.org/10.1371/journal.pntd.0000453 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
3 |
container_issue |
6 |
container_start_page |
e453 |
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1766345144693424128 |