Next Article in Journal
The Impact of Preoperative Risk on the Association between Hypotension and Mortality after Cardiac Surgery: An Observational Study
Previous Article in Journal
Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects
Previous Article in Special Issue
Immunomodulation by an Omega-6 Fatty Acid Reduced Mixed Lipid Emulsion in Murine Acute Respiratory Distress Syndrome
Open AccessArticle

Blood Levels of Free-Circulating Mitochondrial DNA in Septic Shock and Postsurgical Systemic Inflammation and Its Influence on Coagulation: A Secondary Analysis of a Prospective Observational Study

1
Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, 35392 Giessen, Germany
2
German Center of Infection Research, Partner Site Giessen/Marburg/Langen, 35392 Giessen, Germany
3
Excellence Cluster Cardiopulmonary Institute, Member of the German Center for Lung Research, Universities of Giessen and Marburg Lung Center, 35392 Giessen, Germany
4
Department of General and Thoracic Surgery, University Hospital of Giessen, 35392 Giessen, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2056; https://doi.org/10.3390/jcm9072056
Received: 26 May 2020 / Revised: 25 June 2020 / Accepted: 26 June 2020 / Published: 30 June 2020
(This article belongs to the Special Issue Sepsis: Current Clinical Practices and New Perspectives)
Major surgery is regularly associated with clinical signs of systemic inflammation, which potentially affects the rapid identification of sepsis. Therefore, this secondary analysis of an observational study aims to determine whether NADH dehydrogenase 1 (ND1) mitochondrial DNA (mtDNA) could be used as a potential biomarker for the discrimination between septic shock and postsurgical systemic inflammation. Overall, 80 patients were included (septic shock (n = 20), cardiac artery bypass grafting (CABG, n = 20), major abdominal surgery (MAS, n = 20), and matched controls (CTRL, n = 20)). Quantitative PCR was performed to measure ND1 mtDNA. Thromboelastography was used to analyze the coagulatory system. Free-circulating ND1 mtDNA levels were significantly higher in septic shock patients compared to patients suffering from post-surgical inflammation ({copies/µL}: CTRL: 1208 (668–2685); septic shock: 3823 (2170–7318); CABG: 1272 (417–2720); and MAS: 1356 (694–2845); CTRL vs. septic shock: p < 0.001; septic shock vs. CABG: p < 0.001; septic shock vs. MAS: p = 0.006; CABG vs. MAS: p = 0.01). ND1 mtDNA levels in CABG patients showed a strong positive correlation with fibrinogen (correlation coefficient [r]= 0.57, p < 0.001) and fibrinogen-dependent thromboelastographic assays (maximum clot firmness, EXTEM: r = 0.35, p = 0.01; INTEM: r = 0.31, p = 0.02; FIBTEM: r = 0.46, p < 0.001). In conclusion, plasma levels of free-circulating ND1 mtDNA were increased in septic shock patients and were discriminative between sepsis and surgery-induced inflammation. Furthermore, this study showed an association between ND1 mtDNA and a fibrinogen-dependent pro-coagulatory shift in cardiac surgical patients. View Full-Text
Keywords: sepsis; DAMPs; SIRS; inflammation; coagulation; coagulopathy sepsis; DAMPs; SIRS; inflammation; coagulation; coagulopathy
Show Figures

Figure 1

MDPI and ACS Style

Schneck, E.; Edinger, F.; Hecker, M.; Sommer, N.; Pak, O.; Weissmann, N.; Hecker, A.; Reichert, M.; Markmann, M.; Sander, M.; Koch, C. Blood Levels of Free-Circulating Mitochondrial DNA in Septic Shock and Postsurgical Systemic Inflammation and Its Influence on Coagulation: A Secondary Analysis of a Prospective Observational Study. J. Clin. Med. 2020, 9, 2056.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop