A Sustained Reduction in Serum Cholinesterase Enzyme Activity Predicts Patient Outcome following Sepsis

Mediators of Inflammation
Aleksandar R ZivkovicThorsten Brenner

Abstract

Early sepsis identification is of paramount importance for an effective therapy and the patient outcome; however, a suitable prognostic biomarker is lacking. Anti-inflammatory nonneuronal cholinergic signaling modulates the magnitude of an immune response. Serum cholinesterase (BChE), an enzyme that hydrolyzes acetylcholine, plays an important role during inflammatory response and serves as an accurate index of cholinergic activity. BChE activity was measured in septic patients using a point-of-care system, and levels of conventional inflammatory markers and the disease severity scores were obtained. We observed a strong, sustained reduction in BChE activity in patients who died within a 90-day observation period, as compared to survivors. Reduced BChE activity when measured at the ICU admission effectively differentiated between the 90-day survivor and the nonsurvivor patient groups. We estimated a critical BChE level of 1.661 kU/L (CI 0.5-0.8, 94% sensitivity, 48% specificity, AUC 0.7) to best predict patient outcome providing a benchmark criterion for early detection of potentially fatal sepsis measured at the admission. This finding suggests that the BChE activity, used in combination with the laboratory tests, clinical exa...Continue Reading

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Feb 25, 2020·The Journal of International Medical Research·Jun HuangTing Tan
Aug 22, 2020·The Journal of Infection·Kento NakajimaIchiro Takeuchi
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Jan 5, 2022·European Journal of Clinical Investigation·Mei WeiJieshou Li

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Methods Mentioned

BETA
biomarker
X-ray

Software Mentioned

GraphPad Prism
Excel
SPSS

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