Decrease of Proapolipoprotein AI was Associated with Poor Prognosis in Patients with Septic Shock

Kwon,  Woon Yong; Suh,  Gil Joon; Jo,  You Hwan; Kim,  Kyuseok

J Korean Soc Emerg Med > Volume 22(3); 2011 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2011;22(3): 231-241.

Decrease of Proapolipoprotein AI was Associated with Poor Prognosis in Patients with Septic Shock

Woon Yong Kwon, Gil Joon Suh, You Hwan Jo, Kyuseok Kim

Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. suhgil@snu.ac.kr

ABSTRACT

PURPOSE:
Proteomics is a peptide screening approach to identify proteins related to physiological and pathological changes. Our objective was to analyze changes in serum proteome profiles in patients suffering from septic shock, during the first 24-h period of therapy and to determine whether these changes were associated with prognosis.
METHODS:
This was a retrospective observational study based on prospectively collected data that was conducted in an emergency intensive care unit (ICU) of a tertiary referral hospital. Consecutive patients admitted to the ICU with septic shock were enrolled. We obtained serum samples from the patients at admission (0 h) and 24 h after admission (24 h). Then, we analyzed the serum proteome profiles, performed Western blots, and measured serum lipid profiles.
RESULTS:
Twenty-seven patients were enrolled. Thirteen patients were grouped into the survivors (SURV) group and fourteen into the non-survivors group on day 30 (NON-SURV). Proteomic analyses and Western blot showed that the expression intensities of proapolipoprotein AI remained unchanged in SURV but decreased in NON-SURV during the first 24-h period of septic shock (p=0.015). Serum high density lipoprotein (HDL) cholesterol level also remained unchanged in SURV but decreased in NON-SURV (p=0.036).
CONCLUSION:
The decrease in serum proapolipoprotein AI expression during the first 24-h period of therapy was associated with a consistently low serum HDL cholesterol level and a poor prognosis in patients with septic shock.

Key words: Proteomics, Proapolipoprotein AI, High density lipoproteins, Prognosis, Shock, Septic