Decreased Plasma Concentrations of Apolipoprotein M in Sepsis and Systemic Inflammatory Response Syndromes

Critical Care, 04/24/2012

Kumaraswamy SB et al. – During sepsis and systemic inflammatory response syndrome (SIRS), the plasma concentrations of apolipoprotein M (apoM) drop dramatically, the degree of decrease reflecting the severity of the disease. As a carrier for barrier protective sphingosine–1–phosphate (S1P) in high–density lipoprotein (HDL), the decrease in apoM could contribute to the increased vascular leakage observed in sepsis and SIRS.


  • Plasma samples from patients with:
    • Severe sepsis with shock (n=26)
    • Severe sepsis without shock (n=44)
    • Sepsis (n=100)
    • Infections without SIRS (n=43)
    • SIRS without infection (n=20) were analyzed.
  • The concentrations of apoM, apoA1, and apoB were measured with ELISAs.
  • Total- HDL- and LDL-cholesterol concentrations were measured with a commercial HDL/LDL cholesterol test.


  • ApoM concentrations correlated negatively to acute phase markers.
  • Thus, apoM behaved as a negative acute phase protein.
  • Decreased values were observed in all patients groups (P<0.0001), the most drastic decreases observed in the severely sick patients.
  • ApoM levels correlated strongly to those of apoA1, apoB, HDL- and LDL cholesterol.
  • The HDL- and LDL cholesterol levels were low in all patients groups, as compared to controls (P<0.0001), in particular HDL-cholesterol.
  • ApoA1 and apoB concentrations were only low in the more severely affected patients.

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