1. Proteolysis in septic shock patients: plasma peptidomic patterns are associated with mortality
- Author
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Erik B. Kistler, Federico Aletti, Geert W. Schmid-Schönbein, Ricard Ferrer, R. Díaz, Karim Bendjelid, V. Ribas, Bernardo Bollen Pinto, E.M. de Oliveira, Maria Antonia Odena, Eduardo Romay, Gabriella Tedeschi, Antoine Herpain, and Julia Bauzá-Martinez
- Subjects
Male ,0301 basic medicine ,0302 clinical medicine ,Anesthesiology ,80 and over ,2.1 Biological and endogenous factors ,Chymotrypsin ,Hospital Mortality ,Prospective Studies ,Aetiology ,mass spectrometry ,Aged, 80 and over ,ddc:617 ,biology ,medicine.diagnostic_test ,Shock ,Hematology ,Middle Aged ,Shock, Septic ,Infectious Diseases ,Treatment Outcome ,Circulatory system ,Female ,medicine.symptom ,Adult ,proteolysis ,Proteases ,Physical Injury - Accidents and Adverse Effects ,Critical Care ,Proteolysis ,Clinical Sciences ,and over ,Anesthésiologie ,Sepsis ,Young Adult ,03 medical and health sciences ,Clinical Research ,Intensive care ,medicine ,Humans ,Computer Simulation ,Aged ,Septic ,Septic shock ,business.industry ,Inflammatory and immune system ,Organ dysfunction ,peptidomics ,030208 emergency & critical care medicine ,medicine.disease ,Survival Analysis ,Matrix Metalloproteinases ,030104 developmental biology ,Anesthesiology and Pain Medicine ,Immunology ,biology.protein ,septic shock ,Peptides ,business ,in-hospital mortality - Abstract
Background: Uncontrolled proteolysis contributes to cell injury and organ dysfunction in animal models of circulatory shock. We investigated in humans the relationship between septic shock, proteolysis, and outcome. Methods: Intensive care patients with septic shock (n=29) or sepsis (n=6) and non-hospitalised subjects (n=9) were recruited as part of the prospective observational trial ‘ShockOmics’ (ClinicalTrials.gov Identifier NCT02141607). A mass spectrometry-based approach was used to analyse the plasma peptidomes and the origin of circulating peptides from proteolysis in the enrolled subjects. Results: Evidence of systemic proteolysis was indicated by a larger number of circulating peptides in septic shock patients, compared with septic patients and non-hospitalised healthy subjects. The peptide count and abundance in the septic shock patients were greater in patients who died (n=6) than in survivors (n=23), suggesting an association between magnitude of proteolysis and outcome. In silico analysis of the peptide sequences and of the sites of cleavage on the proteins of origin indicated a predominant role for serine proteases, such as chymotrypsin, and matrix metalloproteases in causing the observed proteolytic degradation. Conclusions: Systemic proteolysis is a novel fundamental pathological mechanism in septic shock. Plasma peptidomics is proposed as a new tool to monitor clinical trajectory in septic shock patients. Clinical trial registration: NCT02141607., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2018