Sustained increase in angiopoietin-2, heparin-binding protein, and procalcitonin is associated with severe sepsis.

PURPOSE: The identification of infection at its early stage in vulnerable patients is challenging. This study aimed to investigate potential biomarkers to distinguish patients progressing to severe sepsis from those with uncomplicated sepsis.

MATERIALS AND METHODS: Serum samples were collected from sepsis patients admitted to the emergency department. The mRNA and protein levels of angiopoietin-2 (Ang-2), interleukin-10 (IL-10), heparin-binding protein (HBP), procalcitonin (PCT), adrenomedullin (ADM), and interleukin-6 (IL-6) were evaluated.

RESULTS: Compared to those of healthy individuals (n = 47), mRNA levels of ANG2, IL10, HBP, PCT, and ADM were increased in patients who eventually developed sepsis. ANG2 was the only gene whose expression was significantly increased in patients developing severe sepsis than in those with uncomplicated sepsis. Serum levels of Ang-2, IL-10, HBP, PCT, and IL-6 were also increased in sepsis patients, but only Ang-2, HBP, and PCT were elevated in the serum of patients developing severe septic shock than in those with uncomplicated sepsis. Serum levels of Ang-2, HBP, and PCT were closely associated with the sequential organ failure assessment (SOFA) score of the patients.

CONCLUSIONS: These findings indicated that sustained elevation of Ang-2, HBP, and PCT were associated with severe infection in critically ill patients.