Exploring Albumin Functionality Assays: A Pilot Study on Sepsis Evaluation in Intensive Care Medicine
Abstract
:1. Introduction
2. Results
2.1. Study Population
2.2. Albumin Binding in Patients on Intensive Care Unit (ICU) Admission
2.3. Comparison to Clinically Established Standard Parameters for the Assessment of the Patient’s Condition
2.4. Patient Survival
2.5. Multiple Linear Regression
2.6. Comparison of the Applied Methods for Albumin Binding Efficiency
3. Discussion
4. Material and Methods
4.1. Design, Settings and Study Population
4.2. Measurement of Albumin Concentration
4.3. Estimation of ABiC
4.4. Determination of Binding and Detoxification Efficiency by Electron Paramagnetic Resonance (EPR)-Spectroscopy
4.5. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Control (n = 10) | Sepsis (n = 10) | Septic Shock (n = 6) | p Value | |
---|---|---|---|---|
Anthropometric data | ||||
Age (years) | 58.5 (49.3–62.0) | 62.5 (52.8–79.0) | 61 (54.8–68.0) | 0.551 |
Male sex | 6 (60) | 7 (70) | 5 (83.3) | |
Hematology, biochemistry, and prognostic scores | ||||
Hemoglobin (mmol/L) | 6.9 (5.9–8.7) | 4.9 (4.5–5.5) | 5.9 (5.4–6.2) | 0.141 |
Erythrocytes (1012/L) | 3.5 (2.8–3.9) | 2.7 (2.4–2.8) | 2.9 (2.8–3.2) | 0.026 |
Hematocrit | 0.31 (0.26–0.33) | 0.26 (0.23–0.26) | 0.28 (0.26–0.30) | 0.005 |
Platelets (109/L) | 227 (211–266) | 128 (86–272) | 114 (62–180) | 0.052 |
Leukocytes (109/L) | 9.6 (7.1–11.6) | 10.2 (8.2–12.2) | 15.5 (13.0–17.0) | 0.382 |
C-reactive protein (CRP) (mg/L) | 85 (56–120) | 151 (126–206) | 161 (122–242) | 0.037 |
Procalcitonin (PCT) (ng/mL) | 0.1 (0.1–0.2) | 1.1 (0.6–3.0) | 11.5 (7.8–18.6) | <0.0001 |
Lactate (mg/dL) | 9.0 (5.8–13.3) | 4.6 (0.7–10.6) | 21.6 (18.5–44.4) | 0.02 |
Albumin (g/L) | 36 (28.7–38.1) | 22.5 (20.9–30.2) | 20.7 (19.7–22.1) | 0.005 |
Bilirubin (µmol/L) | 8.5 (3.8–12.5) | 8.5 (6.0–11.8) | 30.0 (27.0–38.0) | <0.0001 |
Creatinine (µmol/L) | 57.5 (54.3–75.5) | 79.0 (60.8–100.5) | 108.5 (83.3–149.5) | 0.107 |
Urea (mmol/L) | 5.5 (4.6–6.8) | 8.6 (5.7–17.3) | 14.6 (9.5–21.9) | 0.029 |
Sodium (mmol/L) | 139 (138–140) | 139 (136–140) | 134 (131–137) | 0.162 |
Potassium (mmol/L) | 4.0 (3.8–4.2) | 3.9 (3.6–4.3) | 4.7 (4.4–4.9) | 0.002 |
Calcium (mmol/L) | 1.2 (1.2–1.2) | 1.1 (1.1–1.2) | 1.2 (1.1–1.3) | 0.192 |
Sequential organ failure assessment (SOFA) score | 1.0 (0.3–1.0) | 6.0 (4.3–7.5) | 10 (10.0–11.5) | <0.0001 |
Reasons for ICU admission n (%) | ||||
Hospital-aquired pneumonia | 0 (0) | 5 (50) | 2 (33.3) | |
Soft tissue infection | 0 (0) | 2 (20) | 1 (16.6) | |
Urosepsis | 0 (0) | 1 (10) | 0 (0) | |
Abdominal infection | 0 (0) | 1 (10) | 0 (0) | |
Spondylodiscitis | 0 (0) | 1 (10) | 0 (0) | |
Mediastinitis | 0 (0) | 0 (0) | 2 (33.3) | |
Endocarditis | 0 (0) | 0 (0) | 1 (16.6) |
ABiC (%) | BE (%) | DTE (%) | ||||
---|---|---|---|---|---|---|
Parameter | r | p-Value | r | p-Value | r | p-Value |
PCT (ng/mL) | −0.55 | 0.0064 | −0.73 | 0.0001 | −0.62 | 0.0016 |
CRP (mg/L) | −0.39 | 0.0656 | −0.48 | 0.0219 | −0.42 | 0.0455 |
SOFA score | −0.53 | 0.0098 | −0.64 | 0.0010 | −0.56 | 0.0058 |
Parameter | Survivors (n = 21) | Non-Survivors (n = 5) | p-Value |
---|---|---|---|
ABiC (%) | 62 (52–81) | 54 (52–62) | 0.313 |
BE (%) | 31 (15–42) | 19 (12–33) | 0.255 |
DTE (%) | 19 (8–35) | 15 (8–24) | 0.720 |
PCT (ng/mL) | 1.0 (0.1–3.5) | 4.4 (0.5–15) | 0.157 |
CRP (mg/L) | 124 (61–189) | 148 (120–213) | 0.283 |
SOFA score | 4 (1–8) | 8 (4–12) | 0.090 |
Parameter | Description |
---|---|
BE (kbG × nG) | binding efficiency |
DTE (LQ/UQ) | detoxification efficiency |
KB A [(1 − C3)/(CAlb × C3)] | binding coefficient of albumin at highest ethanol concentration (17 Vol%) |
KB B [(1 − C3)/(CAlb × C3)] | binding coefficient of albumin at highest ethanol concentration (19 Vol%) |
KB C [(1 − C3)/(CAlb × C3)] | binding coefficient of albumin at highest ethanol concentration (22 Vol%) |
kbG | global binding constant of whole albumin molecule, determined as regression of ratios between relative amounts of spin-probe molecules within both binding sides, strongly and weakly immobilized, to the concentration of ethanol |
nG | amount of spin-probe molecules within both binding sides, strongly and weakly immobilized |
LQ | loading quality—binding property under low ethanol (17 Vol%) and low spin probe (spin probe/albumin ratio 1) conditions |
UQ | unloading quality—binding property under high ethanol (22 Vol%) and high spin probe (spin probe/albumin ratio 3) conditions |
C3 | fraction of unbound fatty acids |
CAlb | patient’s albumin concentration |
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Klinkmann, G.; Waterstradt, K.; Klammt, S.; Schnurr, K.; Schewe, J.-C.; Wasserkort, R.; Mitzner, S. Exploring Albumin Functionality Assays: A Pilot Study on Sepsis Evaluation in Intensive Care Medicine. Int. J. Mol. Sci. 2023, 24, 12551. https://doi.org/10.3390/ijms241612551
Klinkmann G, Waterstradt K, Klammt S, Schnurr K, Schewe J-C, Wasserkort R, Mitzner S. Exploring Albumin Functionality Assays: A Pilot Study on Sepsis Evaluation in Intensive Care Medicine. International Journal of Molecular Sciences. 2023; 24(16):12551. https://doi.org/10.3390/ijms241612551
Chicago/Turabian StyleKlinkmann, Gerd, Katja Waterstradt, Sebastian Klammt, Kerstin Schnurr, Jens-Christian Schewe, Reinhold Wasserkort, and Steffen Mitzner. 2023. "Exploring Albumin Functionality Assays: A Pilot Study on Sepsis Evaluation in Intensive Care Medicine" International Journal of Molecular Sciences 24, no. 16: 12551. https://doi.org/10.3390/ijms241612551