Aspects on sepsis : treatment and markers

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Aspects on sepsis : treatment and markers

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Publication Doctoral Thesis
Title Aspects on sepsis : treatment and markers
Author(s) Gustafsson, Anna
Date 2012
English abstract
Sepsis is one of the greatest challenges in critical care medicine today, while the treatment of sepsis and evaluation of its severity is complicated. The first part of this thesis presents two approaches on the use of antimicrobial peptides in sepsis treatment, relying on both soluble and immobilized peptides. All peptides tested, truncated from human and non-human antimicrobial peptides, did neutralize LPS activity in a dose-dependent manner. Immobilization of the peptides did not inhibit their ability to bind LPS, therefore, the peptides can be considered for extracorporeal LPS removal in sepsis therapy. Interestingly, the soluble peptides inhibited LPS induced cytokine production but potentiated LTA induced cytokine production in human blood. Consequently, care should be taken when considering these peptides in treatment of Gram-positive infections. The second part of this thesis evaluates the inflammatory marker soluble urokinase plasminogen activator receptor (suPAR) in sepsis prognosis. Also, an investigation whether suPAR can be detected in human saliva was undertaken. The results indicate that plasma levels of suPAR are increased in sepsis patients compared to controls, but there was no significant difference between survivors and non-survivors. Plasma levels of suPAR did not correlate with other inflammatory markers, suggesting that suPAR reflects general activation of the immune system rather than exerting inflammatory actions. Moreover, suPAR can be detected in saliva and the levels are more than 10 times higher than the corresponding plasma levels in healthy individuals.
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Publisher Malmö University. Faculty of Health and Society
Series/Issue Doctoral Dissertation;2
ISSN 1653-5383
ISBN 978-91-7104-428-0
Pages 72 s.
Language eng (iso)
Subject(s) antimicrobial peptides
cytokines
lipoteichoic acid
lipopolysaccharide
soluble urokinase plasminogen activator receptor
sepsis
Medicine
Research Subject Categories::MEDICINE
Included papers
  1. Gustafsson A. Olin AI., Ljunggren L. LPS interactions with immobilized and soluble antimicrobial peptides. Scand J Clin Lab Invest. 2010;70:194-200

  2. Gustafsson A, Sigel S, Ljunggren L. The antimicrobial peptide LL37 and its truncated derivatives potentiate proinflammatory cytokine induction by lipoteichoic acid in whole blood. Scand J Clin Lab Invest. 2010;70:512-8

  3. Gustafsson A, Ljunggren L, Bodelsson M, Berkestedt I. The prognostic value of suPAR compared to other inflammatory markers in patients with severe sepsis. Biomarker Insights. 2012;7:39-44

  4. Gustafsson A, Ajeti V, Ljunggren L. Detection of suPAR in the saliva of healthy young adults: comparison with plasma levels. Biomarker Insights. 2011;6:119-25

Handle http://hdl.handle.net/2043/13382 (link to this page)

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