Biomarker Profile of Sepsis-Associated Coagulopathy Using Biochip Assay for Inflammatory Cytokines

Abstract

Disseminated intravascular coagulation (DIC) is a major pathophysiological mechanism of sepsis and greatly increases the risk of death in septic patients. Disseminated intravascular coagulation is a complex physiological phenomenon that involves inappropriate activation of coagulation, inflammation, and endothelial processes. The purpose of this study was to analyze the levels of inflammatory cytokines in the plasma of patients with DIC in order to compare the measured levels with those from healthy individuals, draw correlations, and provide a basis for further biomarker panel development. The inflammatory biomarkers interleukin (IL) 1β, IL-6, IL-8, IL-10, interferon (IFN) γ, vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF) α, monocyte chemoattractant protein (MCP)-1, and epidermal growth factor (EGF) showed significant ( P < .05) elevation in patients with DIC. Interestingly, while numerous correlations were present between IL-β, IL-6, IL-8, IL-10, IFN-γ, TNF-α, MCP-1, and many of the inflammatory cytokines measured, VEGF and EGF exhibited much less extensive correlation, suggesting that their involvement in DIC may be independent of the other investigated inflammatory markers.

Keywords: biochip; disseminated intravascular coagulation; inflammatory cytokines; sepsis-associated coagulopathy.

Figure 1.

Comparison of cytokine levels between DIC patients and healthy individuals. Comparisons were made using the Mann-Whitney t test for nonparametric data with α = .05 as the cutoff for statistical significance. Data are shown as mean ± SEM. DIC indicates disseminated intravascular coagulation; SEM, standard error of the mean.

Figure 2.

Percentage change of inflammatory markers in the blood of DIC patients compared to the normal mean. Data are shown as mean ± SEM on a logarithmic scale. DIC indicates disseminated intravascular coagulation; SEM, standard error of the mean.

Figure 3.

Comparison of cytokine levels between patients with nonovert DIC and overt DIC. Comparisons were made using the Mann-Whitney t test for nonparametric data with α = .05 as the cutoff for statistical significance. Data are shown as mean ± SEM. DIC indicates disseminated intravascular coagulation; SEM, standard error of the mean.