Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial

Pietro Caironi; Serge Masson; Tommaso Mauri; Barbara Bottazzi; Roberto Leone; Michela Magnoli; Simona Barlera; Filippo Mamprin; Andrea Fedele; Alberto Mantovani; Gianni Tognoni; Antonio Pesenti; Luciano Gattinoni; Roberto Latini; Paola Bruzzone; Francesca Pagan; Riccarda Russo; Andrea Confalonieri; Chiara Abbruzzese; Beatrice Vergnano; Stefano Faenza; Antonio Siniscalchi; Elisabetta Pierucci; Andrea Noto; Angelo Pezzi; Paolo Spanu; Vieri Parrini; Roberto Oggioni; Giovanni Stefano Pasetti; Maria Cinzia Casadio; Rosa Buontempo; Sara Carrer; Francesca Piccoli; Tatiana Rizzi; Anselmo Caricato; Monica La Sala; Alessandra Antonaci; Paola Fassini; Silvia Paganini; Virginia Porta; Gabriella Moise; Silvia Marell; Mirella Furia; Maria Cristina Urbano; Roberta Carobbi; Simona Poleni; Hassan Kandil; Andrea Ballotta; Fabrizio Bettini; Manlio Sanseverino; Alessandro Gatta; Francesca Cecchini; Luca Guatteri; Gabriella Ciceri; Ferdinando Raimondi; Roberto Colombo; Sandra Ferraris; Massimo Borelli; Valentina Bellato; Franco Cancellieri; Silvia Senni; Ester Bertocchi; Paola Ferri; Gianpietro Moioli; Alexandra Molin; Giovanni Salati; Pierpaolo Salsi; Emanuela Brunori; Daniele Elisei; Giuseppe Maggio; Federico Guardia Nicola; Marco Cavana; Giacomo Morelli; Arturo Guarino; Michele Isetta; Giorgio Tulli; Valerio Mangani; Nicola Rossi; Marta Ferrari; Francesco Bona; Monica Vay; Teresa Bartoli; Mauro Gallo; Katiuscia Vettoretto; Mauro Della Morte; Enrico Boselli; Daniela Puscio; Monia Bovo; Antonio Galzerano; Manuela Carli; Giovanni Zagara

doi:10.1111/eci.12704

Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial

Pietro Caironi, Serge Masson, Tommaso Mauri, Barbara Bottazzi, Roberto Leone, Michela Magnoli, Simona Barlera, Filippo Mamprin, Andrea Fedele, Alberto Mantovani, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Roberto Latini, Paola Bruzzone, Francesca Pagan, Riccarda Russo, Andrea Confalonieri, Chiara Abbruzzese, Beatrice VergnanoStefano Faenza, Antonio Siniscalchi, Elisabetta Pierucci, Andrea Noto, Angelo Pezzi, Paolo Spanu, Vieri Parrini, Roberto Oggioni, Giovanni Stefano Pasetti, Maria Cinzia Casadio, Rosa Buontempo, Sara Carrer, Francesca Piccoli, Tatiana Rizzi, Anselmo Caricato, Monica La Sala, Alessandra Antonaci, Paola Fassini, Silvia Paganini, Virginia Porta, Gabriella Moise, Silvia Marell, Mirella Furia, Maria Cristina Urbano, Roberta Carobbi, Simona Poleni, Hassan Kandil, Andrea Ballotta, Fabrizio Bettini, Manlio Sanseverino, Alessandro Gatta, Francesca Cecchini, Luca Guatteri, Gabriella Ciceri, Ferdinando Raimondi, Roberto Colombo, Sandra Ferraris, Massimo Borelli, Valentina Bellato, Franco Cancellieri, Silvia Senni, Ester Bertocchi, Paola Ferri, Gianpietro Moioli, Alexandra Molin, Giovanni Salati, Pierpaolo Salsi, Emanuela Brunori, Daniele Elisei, Giuseppe Maggio, Federico Guardia Nicola, Marco Cavana, Giacomo Morelli, Arturo Guarino, Michele Isetta, Giorgio Tulli, Valerio Mangani, Nicola Rossi, Marta Ferrari, Francesco Bona, Monica Vay, Teresa Bartoli, Mauro Gallo, Katiuscia Vettoretto, Mauro Della Morte, Enrico Boselli, Daniela Puscio, Monia Bovo, Antonio Galzerano, Manuela Carli, Giovanni Zagara

Research output: Contribution to journal › Article

36 Citations (Scopus)

Abstract

Background: The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. Materials and methods: Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicentre Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of PTX3 and its changes over time with clinical severity, prevalent and incident organ dysfunctions, 90-day mortality and treatment. Results: PTX3 was high at baseline (72 [33–186] ng/mL) and rose with the severity and number of organ dysfunctions (P < 0·001) and the incidence of subsequent new failures. The PTX3 concentration dropped from day 1 to 7, but this decrease was less pronounced in patients with septic shock (P = 0·0004). Higher concentrations of PTX3 on day 1 predicted incident organ dysfunctions. Albumin supplementation was associated with lower levels of PTX3 in patients with septic shock (P = 0·005) but not in those without shock. In a fully adjusted multivariable model, PTX3 on day 7 predicted 90-day mortality. Smaller drops in PTX3 predicted higher 90-day mortality. Conclusions: In severe sepsis and septic shock, early high PTX3 predict subsequent new organ failures, while a smaller drop in circulating PTX3 over time predicts an increased risk of death. Patients with septic shock show lower levels of PTX3 when assigned to albumin than to crystalloids.

Original language	English
Pages (from-to)	73-83
Number of pages	11
Journal	European Journal of Clinical Investigation
Volume	47
DOIs	https://doi.org/10.1111/eci.12704
Publication status	Published - 2017

Keywords

Aged
Albumin
Albumins
Biochemistry
Biomarkers
C-Reactive Protein
Clinical Biochemistry
Crystalloid Solutions
Female
Fluid Therapy
Humans
Isotonic Solutions
Italy
Linear Models
Male
Middle Aged
Mortality
Multiple Organ Failure
Multivariate Analysis
Prognosis
Randomized Controlled Trials as Topic
Sepsis
Serum Amyloid P-Component
Severity of Illness Index
Shock, Septic
pentraxin 3
prognosis
septic shock
severe sepsis

Access to Document

10.1111/eci.12704

Cite this

Caironi, P., Masson, S., Mauri, T., Bottazzi, B., Leone, R., Magnoli, M., Barlera, S., Mamprin, F., Fedele, A., Mantovani, A., Tognoni, G., Pesenti, A., Gattinoni, L., Latini, R., Bruzzone, P., Pagan, F., Russo, R., Confalonieri, A., Abbruzzese, C., ... Zagara, G. (2017). Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial. European Journal of Clinical Investigation, 47, 73-83. https://doi.org/10.1111/eci.12704

@article{eecbb23bda454e248e3addc5ba48d0fb,

title = "Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial",

abstract = "Background: The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. Materials and methods: Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicentre Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of PTX3 and its changes over time with clinical severity, prevalent and incident organ dysfunctions, 90-day mortality and treatment. Results: PTX3 was high at baseline (72 [33–186] ng/mL) and rose with the severity and number of organ dysfunctions (P < 0·001) and the incidence of subsequent new failures. The PTX3 concentration dropped from day 1 to 7, but this decrease was less pronounced in patients with septic shock (P = 0·0004). Higher concentrations of PTX3 on day 1 predicted incident organ dysfunctions. Albumin supplementation was associated with lower levels of PTX3 in patients with septic shock (P = 0·005) but not in those without shock. In a fully adjusted multivariable model, PTX3 on day 7 predicted 90-day mortality. Smaller drops in PTX3 predicted higher 90-day mortality. Conclusions: In severe sepsis and septic shock, early high PTX3 predict subsequent new organ failures, while a smaller drop in circulating PTX3 over time predicts an increased risk of death. Patients with septic shock show lower levels of PTX3 when assigned to albumin than to crystalloids.",

keywords = "Aged, Albumin, Albumins, Biochemistry, Biomarkers, C-Reactive Protein, Clinical Biochemistry, Crystalloid Solutions, Female, Fluid Therapy, Humans, Isotonic Solutions, Italy, Linear Models, Male, Middle Aged, Mortality, Multiple Organ Failure, Multivariate Analysis, Prognosis, Randomized Controlled Trials as Topic, Sepsis, Serum Amyloid P-Component, Severity of Illness Index, Shock, Septic, pentraxin 3, prognosis, septic shock, severe sepsis, Aged, Albumin, Albumins, Biochemistry, Biomarkers, C-Reactive Protein, Clinical Biochemistry, Crystalloid Solutions, Female, Fluid Therapy, Humans, Isotonic Solutions, Italy, Linear Models, Male, Middle Aged, Mortality, Multiple Organ Failure, Multivariate Analysis, Prognosis, Randomized Controlled Trials as Topic, Sepsis, Serum Amyloid P-Component, Severity of Illness Index, Shock, Septic, pentraxin 3, prognosis, septic shock, severe sepsis",

author = "Pietro Caironi and Serge Masson and Tommaso Mauri and Barbara Bottazzi and Roberto Leone and Michela Magnoli and Simona Barlera and Filippo Mamprin and Andrea Fedele and Alberto Mantovani and Gianni Tognoni and Antonio Pesenti and Luciano Gattinoni and Roberto Latini and Paola Bruzzone and Francesca Pagan and Riccarda Russo and Andrea Confalonieri and Chiara Abbruzzese and Beatrice Vergnano and Stefano Faenza and Antonio Siniscalchi and Elisabetta Pierucci and Andrea Noto and Angelo Pezzi and Paolo Spanu and Vieri Parrini and Roberto Oggioni and Pasetti, {Giovanni Stefano} and Casadio, {Maria Cinzia} and Rosa Buontempo and Sara Carrer and Francesca Piccoli and Tatiana Rizzi and Anselmo Caricato and {La Sala}, Monica and Alessandra Antonaci and Paola Fassini and Silvia Paganini and Virginia Porta and Gabriella Moise and Silvia Marell and Mirella Furia and Urbano, {Maria Cristina} and Roberta Carobbi and Simona Poleni and Hassan Kandil and Andrea Ballotta and Fabrizio Bettini and Manlio Sanseverino and Alessandro Gatta and Francesca Cecchini and Luca Guatteri and Gabriella Ciceri and Ferdinando Raimondi and Roberto Colombo and Sandra Ferraris and Massimo Borelli and Valentina Bellato and Franco Cancellieri and Silvia Senni and Ester Bertocchi and Paola Ferri and Gianpietro Moioli and Alexandra Molin and Giovanni Salati and Pierpaolo Salsi and Emanuela Brunori and Daniele Elisei and Giuseppe Maggio and Nicola, {Federico Guardia} and Marco Cavana and Giacomo Morelli and Arturo Guarino and Michele Isetta and Giorgio Tulli and Valerio Mangani and Nicola Rossi and Marta Ferrari and Francesco Bona and Monica Vay and Teresa Bartoli and Mauro Gallo and Katiuscia Vettoretto and {Della Morte}, Mauro and Enrico Boselli and Daniela Puscio and Monia Bovo and Antonio Galzerano and Manuela Carli and Giovanni Zagara",

year = "2017",

doi = "10.1111/eci.12704",

language = "English",

volume = "47",

pages = "73--83",

journal = "European Journal of Clinical Investigation",

issn = "0014-2972",

publisher = "Blackwell Science Limited:PO Box 88, Oxford OX2 0NE United Kingdom:011 44 1865 776868, 011 44 1865 206038, EMAIL: journals.cs@blacksci.co.uk, INTERNET: http://www.blackwell-science.com, Fax: 011 44 1865 721205",

}

Caironi, P, Masson, S, Mauri, T, Bottazzi, B, Leone, R, Magnoli, M, Barlera, S, Mamprin, F, Fedele, A, Mantovani, A, Tognoni, G, Pesenti, A, Gattinoni, L, Latini, R, Bruzzone, P, Pagan, F, Russo, R, Confalonieri, A, Abbruzzese, C, Vergnano, B, Faenza, S, Siniscalchi, A, Pierucci, E, Noto, A, Pezzi, A, Spanu, P, Parrini, V, Oggioni, R, Pasetti, GS, Casadio, MC, Buontempo, R, Carrer, S, Piccoli, F, Rizzi, T, Caricato, A, La Sala, M, Antonaci, A, Fassini, P, Paganini, S, Porta, V, Moise, G, Marell, S, Furia, M, Urbano, MC, Carobbi, R, Poleni, S, Kandil, H, Ballotta, A, Bettini, F, Sanseverino, M, Gatta, A, Cecchini, F, Guatteri, L, Ciceri, G, Raimondi, F, Colombo, R, Ferraris, S, Borelli, M, Bellato, V, Cancellieri, F, Senni, S, Bertocchi, E, Ferri, P, Moioli, G, Molin, A, Salati, G, Salsi, P, Brunori, E, Elisei, D, Maggio, G, Nicola, FG, Cavana, M, Morelli, G, Guarino, A, Isetta, M, Tulli, G, Mangani, V, Rossi, N, Ferrari, M, Bona, F, Vay, M, Bartoli, T, Gallo, M, Vettoretto, K, Della Morte, M, Boselli, E, Puscio, D, Bovo, M, Galzerano, A, Carli, M & Zagara, G 2017, 'Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial', European Journal of Clinical Investigation, vol. 47, pp. 73-83. https://doi.org/10.1111/eci.12704

TY - JOUR

T1 - Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial

AU - Caironi, Pietro

AU - Masson, Serge

AU - Mauri, Tommaso

AU - Bottazzi, Barbara

AU - Leone, Roberto

AU - Magnoli, Michela

AU - Barlera, Simona

AU - Mamprin, Filippo

AU - Fedele, Andrea

AU - Mantovani, Alberto

AU - Tognoni, Gianni

AU - Pesenti, Antonio

AU - Gattinoni, Luciano

AU - Latini, Roberto

AU - Bruzzone, Paola

AU - Pagan, Francesca

AU - Russo, Riccarda

AU - Confalonieri, Andrea

AU - Abbruzzese, Chiara

AU - Vergnano, Beatrice

AU - Faenza, Stefano

AU - Siniscalchi, Antonio

AU - Pierucci, Elisabetta

AU - Noto, Andrea

AU - Pezzi, Angelo

AU - Spanu, Paolo

AU - Parrini, Vieri

AU - Oggioni, Roberto

AU - Pasetti, Giovanni Stefano

AU - Casadio, Maria Cinzia

AU - Buontempo, Rosa

AU - Carrer, Sara

AU - Piccoli, Francesca

AU - Rizzi, Tatiana

AU - Caricato, Anselmo

AU - La Sala, Monica

AU - Antonaci, Alessandra

AU - Fassini, Paola

AU - Paganini, Silvia

AU - Porta, Virginia

AU - Moise, Gabriella

AU - Marell, Silvia

AU - Furia, Mirella

AU - Urbano, Maria Cristina

AU - Carobbi, Roberta

AU - Poleni, Simona

AU - Kandil, Hassan

AU - Ballotta, Andrea

AU - Bettini, Fabrizio

AU - Sanseverino, Manlio

AU - Gatta, Alessandro

AU - Cecchini, Francesca

AU - Guatteri, Luca

AU - Ciceri, Gabriella

AU - Raimondi, Ferdinando

AU - Colombo, Roberto

AU - Ferraris, Sandra

AU - Borelli, Massimo

AU - Bellato, Valentina

AU - Cancellieri, Franco

AU - Senni, Silvia

AU - Bertocchi, Ester

AU - Ferri, Paola

AU - Moioli, Gianpietro

AU - Molin, Alexandra

AU - Salati, Giovanni

AU - Salsi, Pierpaolo

AU - Brunori, Emanuela

AU - Elisei, Daniele

AU - Maggio, Giuseppe

AU - Nicola, Federico Guardia

AU - Cavana, Marco

AU - Morelli, Giacomo

AU - Guarino, Arturo

AU - Isetta, Michele

AU - Tulli, Giorgio

AU - Mangani, Valerio

AU - Rossi, Nicola

AU - Ferrari, Marta

AU - Bona, Francesco

AU - Vay, Monica

AU - Bartoli, Teresa

AU - Gallo, Mauro

AU - Vettoretto, Katiuscia

AU - Della Morte, Mauro

AU - Boselli, Enrico

AU - Puscio, Daniela

AU - Bovo, Monia

AU - Galzerano, Antonio

AU - Carli, Manuela

AU - Zagara, Giovanni

PY - 2017

Y1 - 2017

N2 - Background: The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. Materials and methods: Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicentre Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of PTX3 and its changes over time with clinical severity, prevalent and incident organ dysfunctions, 90-day mortality and treatment. Results: PTX3 was high at baseline (72 [33–186] ng/mL) and rose with the severity and number of organ dysfunctions (P < 0·001) and the incidence of subsequent new failures. The PTX3 concentration dropped from day 1 to 7, but this decrease was less pronounced in patients with septic shock (P = 0·0004). Higher concentrations of PTX3 on day 1 predicted incident organ dysfunctions. Albumin supplementation was associated with lower levels of PTX3 in patients with septic shock (P = 0·005) but not in those without shock. In a fully adjusted multivariable model, PTX3 on day 7 predicted 90-day mortality. Smaller drops in PTX3 predicted higher 90-day mortality. Conclusions: In severe sepsis and septic shock, early high PTX3 predict subsequent new organ failures, while a smaller drop in circulating PTX3 over time predicts an increased risk of death. Patients with septic shock show lower levels of PTX3 when assigned to albumin than to crystalloids.

AB - Background: The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. Materials and methods: Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicentre Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of PTX3 and its changes over time with clinical severity, prevalent and incident organ dysfunctions, 90-day mortality and treatment. Results: PTX3 was high at baseline (72 [33–186] ng/mL) and rose with the severity and number of organ dysfunctions (P < 0·001) and the incidence of subsequent new failures. The PTX3 concentration dropped from day 1 to 7, but this decrease was less pronounced in patients with septic shock (P = 0·0004). Higher concentrations of PTX3 on day 1 predicted incident organ dysfunctions. Albumin supplementation was associated with lower levels of PTX3 in patients with septic shock (P = 0·005) but not in those without shock. In a fully adjusted multivariable model, PTX3 on day 7 predicted 90-day mortality. Smaller drops in PTX3 predicted higher 90-day mortality. Conclusions: In severe sepsis and septic shock, early high PTX3 predict subsequent new organ failures, while a smaller drop in circulating PTX3 over time predicts an increased risk of death. Patients with septic shock show lower levels of PTX3 when assigned to albumin than to crystalloids.

KW - Aged

KW - Albumin

KW - Albumins

KW - Biochemistry

KW - Biomarkers

KW - C-Reactive Protein

KW - Clinical Biochemistry

KW - Crystalloid Solutions

KW - Female

KW - Fluid Therapy

KW - Humans

KW - Isotonic Solutions

KW - Italy

KW - Linear Models

KW - Male

KW - Middle Aged

KW - Mortality

KW - Multiple Organ Failure

KW - Multivariate Analysis

KW - Prognosis

KW - Randomized Controlled Trials as Topic

KW - Sepsis

KW - Serum Amyloid P-Component

KW - Severity of Illness Index

KW - Shock, Septic

KW - pentraxin 3

KW - prognosis

KW - septic shock

KW - severe sepsis

KW - Aged

KW - Albumin

KW - Albumins

KW - Biochemistry

KW - Biomarkers

KW - C-Reactive Protein

KW - Clinical Biochemistry

KW - Crystalloid Solutions

KW - Female

KW - Fluid Therapy

KW - Humans

KW - Isotonic Solutions

KW - Italy

KW - Linear Models

KW - Male

KW - Middle Aged

KW - Mortality

KW - Multiple Organ Failure

KW - Multivariate Analysis

KW - Prognosis

KW - Randomized Controlled Trials as Topic

KW - Sepsis

KW - Serum Amyloid P-Component

KW - Severity of Illness Index

KW - Shock, Septic

KW - pentraxin 3

KW - prognosis

KW - septic shock

KW - severe sepsis

UR - http://hdl.handle.net/10807/130479

UR - http://www3.interscience.wiley.com/journal/118482631/home

U2 - 10.1111/eci.12704

DO - 10.1111/eci.12704

M3 - Article

SN - 0014-2972

VL - 47

SP - 73

EP - 83

JO - European Journal of Clinical Investigation

JF - European Journal of Clinical Investigation

ER -

Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this