Cytochrome C in Patients with Septic Shock

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Lars Wiuff Andersen
  • Xiaowen Liu
  • ,
  • Sophia Montissol
  • ,
  • Mathias J Holmberg
  • Christopher Sulmonte
  • ,
  • Julia L Balkema
  • ,
  • Michael N Cocchi
  • ,
  • Raúl J Gazmuri
  • ,
  • Kathrine M Berg
  • ,
  • Maureen Chase
  • ,
  • Michael W Donnino

PURPOSE: Cytochrome c is an essential component of the electron transport chain and circulating cytochrome c might be an indicator of mitochondrial injury. The objective of this study was to determine whether cytochrome c levels are elevated in septic patients, whether there is an association between cytochrome c levels and lactate/inflammatory markers, and whether elevated levels of cytochrome c are associated with poor outcomes.

METHODS: This was a single-center, prospective, observational, pilot study within a randomized, placebo-controlled trial. We enrolled adult patients in septic shock and with an elevated lactate (> 3 mmol/L). Blood was collected at enrollment and at 12 and 24 hours thereafter. Cytochrome c was measured in plasma using an electrochemiluminescence immunoassay.

RESULTS: We included 77 patients. Plasma cytochrome c levels were significantly higher in septic patients as compared to healthy controls (0.70 ng/mL [quartiles: 0.06, 1.99] vs. 0.19 ng/mL [quartiles: 0.03, 1.32], p = 0.008). Cytochrome c levels at enrollment were positively correlated with lactate levels (rs = 0.40, p < 0.001) but not with inflammatory markers. Patients who died before hospital discharge had significantly higher cytochrome c levels as compared to survivors (0.99 ng/mL [quartiles: 0.36, 4.09] vs. 0.58 ng/mL [quartiles: 0.03, 1.64], p = 0.01). When analyzed over time, the difference between survivors and non-survivors remained significant (p < 0.001).

CONCLUSION: Cytochrome c levels are higher in septic patients as compared to controls. In unadjusted analysis, septic non-survivors had higher cytochrome c levels than survivors.

StatusUdgivet - maj 2016

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