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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.
Methods- 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.
