Changes in the serum levels of clusterin in children with sepsis

Aim: The first aim of this study was to determine levels of clusterin in pediatric patients with systemic inflammatory response syndrome or septic state, comparing these levels with a healthy population. The second objective was to compare levels of clusterin within individual septic conditions, influence of levels of these proteins on mortality. Background: Clusterin is a highly conserved protein which is expressed at increased levels by many cell types in response to a broad variety of stress conditions. Methods: Fifty-seven children aged 0-19 years (30 boys and 27 girls) hospitalized from June 2009 to March 2011, with expected or proven SIRS and septic condition. The degree of severity was evaluated according PELOD Score. Blood tests to determine levels of clusterin were taken throughout the patient meets the criteria of SIRS or sepsis. Control group to determine the serum levels of clusterin has been taken from patients undergoing elective surgery. Results: We found lower concentrations of clusterin in patients with SIRS or septic state, than in the control group. Clusterin cut-off for first day - D1 was 91.04 μg/ml; AUC 0.900; p-value <0.001; for third day - D3 was cut-off 86.73 μg/ml; AUC 0.849; p-value <0.001; for fifth day - D5 cut-off was 105.26 μg/ml; AUC 0.755; p-value <0.001. Effect of clusterin levels on mortality in the dynamics was recorded significant for 5 days in groups non-survivors/survivors, p-value 0.004. Conclusion: We have demonstrated a decrease clusterin levels in pediatric patients with septic state, and its effect on mortality.