Clinical Medicine Research

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The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis

Received: 31 March 2016    Accepted: 14 April 2016    Published: 28 April 2016
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Abstract

Background: There are many biomarkers defined for systemic inflammation and sepsis. Cholinesterase and its biological role is not entirely known but in recent studies, it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Objective: The purpose of this study is to establish the role of cholinesterase activity as a biomarker in the early diagnosis and treatment planning of sepsis which is an uncontrolled inflammatory response of the host to an infection. Materials and Method: This is a controlled, observational, and prospective clinical study and has been carried out on patients admitted to the intensive care unit with sepsis. The demographic features, the medical history and vital findings of the patients were recorded. According to the intensive care monitoring and treatment procedures, the complete blood count test, urine test and routine biochemical assessments particularly the CRP, procalcitonin and blood gasses tests were performed and the serum cholinesterase activity was assessed. The data was digitalized and then analyzed using the SPSS 15.0 software package. Results: The cholinesterase levels detected in the patient group were lower than the cholinesterase levels of the control group and there was a significant difference between the groups (p< 0.001). A statistically significant association was detected between the severity of sepsis and the cholinesterase levels of the patients. There was also a statistical relationship between the cholinesterase levels and being connected to mechanical ventilation and the use of vasopressors (p<0.05). There was a significant association between mortality and cholinesterase levels (p= 0.009). As the cholinesterase activity decreased the mortality rate increased. As a result of the ROC analyses performed to establish the diagnostic value of the patients' cholinesterase levels in predicting sepsis and morality it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Conclusions: We believe that the cholinesterase activity investigated in our study is an extremely useful biomarker in the diagnosis and prognosis prediction of the sepsis syndrome that progresses with systemic inflammation.

DOI 10.11648/j.cmr.20160503.13
Published in Clinical Medicine Research (Volume 5, Issue 3, May 2016)
Page(s) 28-34
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sepsis, Cholinesterase, Inflammation

References
[1] Snyderman R, Gallin JI, Goldstein IM. Inflammation: basic principles and clinical correlates: Raven Press; 1992.
[2] Kumar V, Abbas AK, Fausto N, Aster J. Pathologic basis of disease. Philadelphia, PA: Elsevier Saunders; 2005.
[3] Alberti C, Brun-Buisson C, Goodman SV, Guidici D, Granton J, Moreno R, et al. Influence of systemic inflammatory response syndrome and sepsis on outcome of critically ill infected patients. American journal of respiratory and critical care medicine. 2003; 168 (1): 77-84.
[4] Pierrakos C, Vincent J-L. Sepsis biomarkers: a review. Crit Care. 2010; 14 (1): R15.
[5] Borovikova LV, Ivanova S, Zhang M, Yang H, Botchkina GI, Watkins LR, et al. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000; 405 (6785): 458-62.
[6] Wang H, Yu M, Ochani M, Amella CA, Tanovic M, Susarla S, et al. Nicotinic acetylcholine receptor α7 subunit is an essential regulator of inflammation. Nature. 2003; 421 (6921): 384-8.
[7] Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest Journal. 1992; 101 (6): 1644-55.
[8] Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. New England Journal of Medicine. 2003; 348 (2): 138-50.
[9] Fauci AS. Harrison's principles of internal medicine: McGraw-Hill Medical New York; 2008.
[10] Moss M, Martin G. A global perspective on the epidemiology of sepsis. Intensive care medicine. 2004; 30 (4): 527-9.
[11] Young E, Mandell G, Bennett J, Dolin R. Principles and practice of infectious diseases. Principles and Practice of Infectious Diseases. 2000.
[12] Lehr HA, Bittinger F, Kirkpatrick CJ. Microcirculatory dysfunction in sepsis: a pathogenetic basis for therapy? The Journal of pathology. 2000; 190 (3): 373-86.
[13] van der Poll T, van Deventer SJ. Cytokines and anticytokines in the pathogenesis of sepsis. Infectious disease clinics of North America. 1999; 13 (2): 413-26.
[14] Paterson RL, NR W. Sepsis and the SIRS: JR Coll Surg Edin 2000. 178-82 p.
[15] Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive care medicine. 2013; 39 (2): 165-228.
[16] Carson SS, Stocking C, Podsadecki T, Christenson J, Pohlman A, MacRae S, et al. Effects of organizational change in the medical intensive care unit of a teaching hospital: a comparison of' open and closed formats. Jama. 1996; 276 (4): 322-8.
[17] Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical Care Medicine-Baltimore-. 2001; 29 (7): 1303-10.
[18] Nguyen DN, Spapen H, Su F, Schiettecatte J, Shi L, Hachimi-Idrissi S, et al. Elevated serum levels of S-100β protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock*. Critical care medicine. 2006; 34 (7): 1967-74.
[19] Lai CC, Chen SY, Wang CY, Wang JY, Su CP, Liao CH, et al. Diagnostic value of procalcitonin for bacterial infection in elderly patients in the emergency department. Journal of the American Geriatrics Society. 2010; 58 (3): 518-22.
[20] Boussekey N, Cantrel J, Dorchin Debrabant L, Langlois J, Devos P, Meybeck A, et al. Epidemiology, prognosis, and evolution of management of septic shock in a French intensive care unit: a five years survey. Critical care research and practice. 2010; 2010.
[21] Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel RP. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clinical infectious diseases. 1999; 29 (2): 239-44.
[22] DW H, JM L. Sepsis. Philadelphia: W. B. Saunders Company; 1998.
[23] Valles J, Rello J, Ochagavia A, Garnacho J, Alcalá MA. Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. CHEST Journal. 2003; 123 (5): 1615-24.
[24] Povoa P, Coelho L, Almeida E, Fernandes A, Mealha R, Moreira P, et al. C‐reactive protein as a marker of infection in critically ill patients. Clinical microbiology and infection. 2005; 11 (2): 101-8.
[25] Suprin E, Camus C, Gacouin A, Le Tulzo Y, Lavoue S, Feuillu A, et al. Procalcitonin: a valuable indicator of infection in a medical ICU? Intensive care medicine. 2000; 26 (9): 1232-8.
[26] Müller B, Becker KL, Schächinger H, Rickenbacher PR, Huber PR, Zimmerli W, et al. Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit. Critical care medicine. 2000; 28 (4): 977-83.
[27] Brunkhorst F, Al-Nawas B, Krummenauer F, Forycki Z, Shah P. Procalcitonin, C-reactive protein and APACHE II score for risk evaluation in patients with severe pneumonia. Clinical microbiology and infection. 2002; 8 (2): 93-100.
[28] Feng W, Tang C, Guo H, Bao Y, Wen X, Xue T, et al. Prognostic value of serum cholinesterase activities in sepsis patients. Hepato-gastroenterology. 2012; 60 (125): 1001-5.
[29] Setoguchi D, Yatsuki H, Sadahiro T, Nakamura M, Hirayama Y, Watanabe E, et al. Effects of a peripheral cholinesterase inhibitor on cytokine production and autonomic nervous activity in a rat model of sepsis. Cytokine. 2012; 57 (2): 238-44.
[30] Chiarla C, Giovannini I, Giuliante F, Vellone M, Ardito F, Nuzzo G. Plasma cholinesterase correlations in acute surgical and critical illness. Minerva chirurgica. 2011; 66 (4): 323-7.
[31] Fernandez‐Cabezudo MJ, Lorke DE, Azimullah S, Mechkarska M, Hasan MY, Petroianu GA, et al. Cholinergic stimulation of the immune system protects against lethal infection by Salmonella enterica serovar Typhimurium. Immunology. 2010; 130 (3): 388-98.
[32] Al-Kassab A, Vijayakumar E. Profile of serum cholinesterase in systemic sepsis syndrome (septic shock) in intensive care unit patients. Clinical Chemistry and Laboratory Medicine. 1995; 33 (1): 11-4.
[33] Wolkmer P, da Silva CB, Paim FC, Duarte MM, Castro V, Palma HE, et al. Pre-treatment with curcumin modulates acetylcholinesterase activity and proinflammatory cytokines in rats infected with Trypanosoma evansi. Parasitology international. 2013; 62 (2): 144-9.
Author Information
  • Konya Training and Research Hospital, Biochemistry Department, Konya, Turkey

  • Konya Training and Research Hospital, Emergency Department, Konya, Turkey

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  • APA Style

    Oznur Koylu, Mehmet Yortanli. (2016). The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis. Clinical Medicine Research, 5(3), 28-34. https://doi.org/10.11648/j.cmr.20160503.13

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    ACS Style

    Oznur Koylu; Mehmet Yortanli. The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis. Clin. Med. Res. 2016, 5(3), 28-34. doi: 10.11648/j.cmr.20160503.13

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    AMA Style

    Oznur Koylu, Mehmet Yortanli. The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis. Clin Med Res. 2016;5(3):28-34. doi: 10.11648/j.cmr.20160503.13

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  • @article{10.11648/j.cmr.20160503.13,
      author = {Oznur Koylu and Mehmet Yortanli},
      title = {The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis},
      journal = {Clinical Medicine Research},
      volume = {5},
      number = {3},
      pages = {28-34},
      doi = {10.11648/j.cmr.20160503.13},
      url = {https://doi.org/10.11648/j.cmr.20160503.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20160503.13},
      abstract = {Background: There are many biomarkers defined for systemic inflammation and sepsis. Cholinesterase and its biological role is not entirely known but in recent studies, it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Objective: The purpose of this study is to establish the role of cholinesterase activity as a biomarker in the early diagnosis and treatment planning of sepsis which is an uncontrolled inflammatory response of the host to an infection. Materials and Method: This is a controlled, observational, and prospective clinical study and has been carried out on patients admitted to the intensive care unit with sepsis. The demographic features, the medical history and vital findings of the patients were recorded. According to the intensive care monitoring and treatment procedures, the complete blood count test, urine test and routine biochemical assessments particularly the CRP, procalcitonin and blood gasses tests were performed and the serum cholinesterase activity was assessed. The data was digitalized and then analyzed using the SPSS 15.0 software package. Results: The cholinesterase levels detected in the patient group were lower than the cholinesterase levels of the control group and there was a significant difference between the groups (p< 0.001). A statistically significant association was detected between the severity of sepsis and the cholinesterase levels of the patients. There was also a statistical relationship between the cholinesterase levels and being connected to mechanical ventilation and the use of vasopressors (p<0.05). There was a significant association between mortality and cholinesterase levels (p= 0.009). As the cholinesterase activity decreased the mortality rate increased. As a result of the ROC analyses performed to establish the diagnostic value of the patients' cholinesterase levels in predicting sepsis and morality it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Conclusions: We believe that the cholinesterase activity investigated in our study is an extremely useful biomarker in the diagnosis and prognosis prediction of the sepsis syndrome that progresses with systemic inflammation.},
     year = {2016}
    }
    

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  • TY  - JOUR
    T1  - The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis
    AU  - Oznur Koylu
    AU  - Mehmet Yortanli
    Y1  - 2016/04/28
    PY  - 2016
    N1  - https://doi.org/10.11648/j.cmr.20160503.13
    DO  - 10.11648/j.cmr.20160503.13
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 28
    EP  - 34
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20160503.13
    AB  - Background: There are many biomarkers defined for systemic inflammation and sepsis. Cholinesterase and its biological role is not entirely known but in recent studies, it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Objective: The purpose of this study is to establish the role of cholinesterase activity as a biomarker in the early diagnosis and treatment planning of sepsis which is an uncontrolled inflammatory response of the host to an infection. Materials and Method: This is a controlled, observational, and prospective clinical study and has been carried out on patients admitted to the intensive care unit with sepsis. The demographic features, the medical history and vital findings of the patients were recorded. According to the intensive care monitoring and treatment procedures, the complete blood count test, urine test and routine biochemical assessments particularly the CRP, procalcitonin and blood gasses tests were performed and the serum cholinesterase activity was assessed. The data was digitalized and then analyzed using the SPSS 15.0 software package. Results: The cholinesterase levels detected in the patient group were lower than the cholinesterase levels of the control group and there was a significant difference between the groups (p< 0.001). A statistically significant association was detected between the severity of sepsis and the cholinesterase levels of the patients. There was also a statistical relationship between the cholinesterase levels and being connected to mechanical ventilation and the use of vasopressors (p<0.05). There was a significant association between mortality and cholinesterase levels (p= 0.009). As the cholinesterase activity decreased the mortality rate increased. As a result of the ROC analyses performed to establish the diagnostic value of the patients' cholinesterase levels in predicting sepsis and morality it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Conclusions: We believe that the cholinesterase activity investigated in our study is an extremely useful biomarker in the diagnosis and prognosis prediction of the sepsis syndrome that progresses with systemic inflammation.
    VL  - 5
    IS  - 3
    ER  - 

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