Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi

Cinel, Ismail; Bilgili, Beliz

Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi

Beliz BİLGİLİ, (Marmara Üniversitesi, Pendik Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye)

İsmail CİNEL (Marmara Üniversitesi, Pendik Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye)

Türk Yoğun Bakım Dergisi

2 1

Yıl: 2013 Cilt: 11 Sayı: 1 Sayfa Aralığı: 33 - 39 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi

Öz:

ÖZET İnflamasyon ve koagülasyona eğilim,çeşitli kritik hastalık durumlarında anahtarpatojenik faktörlerdir. Soluble urokinaseplasminogen activator (suPAR) immünolojikolarak aktif hücrelerden salınan, fibrinolizve inflamasyonu yansıtan bir belirteçtir.Artmış suPAR seviyeleri, inflamasyon venfeksiyon gibi durumlarda immun sistemaktivasyonunu yansıtır. Sistemik inflamatuaryanıt sendromu, bakteriyemi ve sepsisteartmış suPAR düzeyleri bildirilmiştir veyüksek düzeyler kritik hastalarda kötüprognozla ilişkilendirilmektedir. Bu hastagrubunda suPAR hastalık şiddeti ile ilişkiliskorlara benzer prediktif değere sahiptir.suPARın diagnostik önemi, C-reaktif proteinCRP) ve prokalsitonin (PCT) gibi diğerbelirteçlerle karşılaştırıldığında tam olarakanımlanamamıştır. Bu derlemede, suPARınkritik hastalarda önemine genel bir bakış

Anahtar Kelime:

Konular: Yoğun Bakım, Tıp

The significance of soluble urokinase plasminogen activator receptor (suPAR) in ICU Patients

Öz:

SUMMARY Inflamation and tendencytowards to coagulation are key pathogenicfactors in various conditions of criticalillness. Soluble urokinase plasminogenactivator (suPAR), is a biomarker offibrinolysis and inflammation, expressed inimmunologically active cells. High serumsuPAR concentrations are suggested toreflect the activation of the immune systemin circumstances of inflammation andinfection. In critically ill patients, elevatedsuPAR levels in systemic inflammatoryresponse syndrome (SIRS) and sepsis, inwhich high levels indicate poor prognosis.suPAR may have predictive value similarto disease severity scores in these patientpopulation. The diagnostic value of suPARhas not been well defined, compared toother biomarkers, such as C-reactive protein(CRP) and procalcitonin (PCT). This reviewprovides an overview of the value of suPAR in the critically ill patients.

Anahtar Kelime:

Konular: Yoğun Bakım, Tıp

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Hotchkiss RS, Monneret G, Payen D. Immunosuppression in sepsis: a novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis 2013;13:260-8.
2. Cinel I, Opal SM. Molecular biology of inflammation and sepsis: a primer. Crit Care Med 2009;37:291-304.
3. Annane D, Timsit JF, Megarbane B, Martin C, Misset B, Mourvillier B, et al. Recombinant Human Activated Protein C for Adults with Septic Shock: a Randomized Controlled Trial. Am J Respir Crit Care Med 2013 Mar 22. [Epub ahead of print]
4. Abraham E, Laterre PF, Garg R, Levy H, Talwar D, Trzaskoma BL, et al. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med 2005; 353:1332-41
5. Nadel S, Goldstein B, Williams MD, Dalton H, Peters M, Macias WL, et al. Drotrecogin alfa (activated) in children with severe sepsis: A multicentre phase III randomised controlled trial. Lancet 2007;369:836-43.
6. http://www.fda.gov/Drugs/DrugSafety/ DrugSafetyPodcasts/ucm277212.htm. Accessed December 18, 2011.
7. Trzeciak S, Cinel I, Dellinger RP, Shapiro NI, Arnold RC, Parrillo JE, et al. Resuscitating the microcirculation in sepsis: the central role of nitric oxide, emerging concepts for novel therapies, and challenges for clinical trials. Acad Emerg Med 2008;15:399-413.
8. LaRosa SP, Opal SM. Biomarkers: the future. Crit Care Clin 2011;27:407-19.
9. Svendsen MN, Ytting H, Brünner N, Nielsen HJ, Christensen IJ. Preoperative concentrations of suPAR and MBL proteins are associated with the development of pneumonia after elective surgery for colorectal cancer. Surgical Infections 2006;7:463-71.
10. Huttunen R, Syrjanen J, Vuento R, Hurme M, Huhtala H, Laine J, et al. Plasma level of soluble urokinase-type plasminogen activator receptor as a predictor of disease severity and case fatality in patients with bacteraemia: a prospective cohort study. J Intern Med 2011;270:32-40.
11. Backes Y, Van der Sluijs K, Mackie DP, Tacke F, Koch A, Tenhunen JJ, et al. Usefulness of suPAR as a biological marker in patients with systemic inflammation or infection: a systematic review. Intensive Care Med 2012;38:1418-28.
12. Wittenhagen P, Kronborg G, Weis N, Obel N, Pedersen SS, et al. The plasma level of soluble urokinase receptor is elevated in patients with streptococcus pneumoniae bacteraemia and predicts mortality. Clin Microbiol Infect 2004;10:409-15.
13. Ostergaard c, Benfield T, Lundgren JD, Eugen-Olsen J. Soluble urokinase receptor is elevated in cerebrospinal fluid from patients with purulent meningitis and is associated with fatal outcome. Scand J Infect Dis 2004;36:14-19.
14. Sidenius N, Sier CF, Ullum H, Pedersen BK, Lepri AC, Blasi F, et al. Serum level of soluble urokinase-type plasminogen activator receptor is a strong and independent predictor of survival in human immunodeficiency virus infection. Blood 2000;96:4091-5.
15. Lawn SD, Myer L, Bangani N, Vogt M, Wood R. Plasma levels of soluble urokinase-type plasminogen activator receptor (suPAR) and early mortality risk among patients enrolling for antiretroviral treatment in South Africa. BMC Infect Dis 2007;7:41.
16. Eugen-Olsen J, Gustafson P, Sidenius N, Fischer TK, Parner J, Aaby P, et al. The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea- Bissau. Int J Tuberc Lung Dis 2002;6:686-92.
17. Rabna P, Andersen A, Wejse C, Oliveira I, Gomes VF, Haaland MB, et al. Utility of the plasma level of suPAR in monitoring risk of mortality during TB treatment. PLoS ONE 2012;7:e43933
18. Lynqbaek S, Marrott JL, Sehestedt T, Hansen TW, Olsen MH, Andersen O, et al. Cardiovascular risk prediction in the general population with use of suPAR, CRP and Framingham risk score. Int J Cardiol 2012 Aug 18. [Epub ahead of print]
19. Edsfeldt A, Nitulescu M, Grufman H, Grönberg C, Perrson A, Nilsson M, et al. Soluble urokinase plasminogen activator receptor is associated with inflammation in the vulnerable human atherosclerotic plaque. Stroke 2012;43:3305-12.
20. Lynqbaek S, Marrott JL, Moller DV, Christiansen M, Iversen KK, Clemmensen PM, et al. Usefulness of soluble urokinase plasminogen activator receptor to predict repeat myocardial infarction and mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention. Am J Cardiol 2012;15;110:1756-63.
21. Toldi G, Szalay B, Beko G, Bocskai M, Deak M, Kovacs L, et al. Plasma soluble urokinase plasminogen activator receptor (suPAR) levels in systemic lupus erythematosus. Biomarkers 2012;17:758-63.
22. Lanqkilde A, Hansen TW, Ladelund S, Linneberg A, Andersen O, Hauqaard SB, et al. Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals. Cancer Epidemiol Biomarkers Prev 2011;20:609-18.
23. Stephens RW, Nielsen HJ, Christensen IJ, Thorlacius-Ussing O, Sorensen S, Dano K, et al. Plasma urokinase receptor levels in patients with colorectal cancer: relationship to prognosis. J Natl Cancer Inst 1999;91:869-74.
24. Brunner N, Nielsen HJ, Hamers M, Christensen IJ, Thorlacius-Ussing O, Stephens RW. The urokinase plasminogen activator receptor in blood from healty individuals and patients with cancer. APMIS 1999;107:160-7.
25. Zimmermann HW, Koch A, Seidler S, Trautwein C, Tacke F. Circulating soluble urokinase plasminogen activator is eleated in patients with chronic liver disease, discriminates stage and aetiology of cirrhosis and predicts prognosis. Liver Int 2012;32:500-9.
26. Wei C, El Hindi S, Li J, Fornoni A, Goes N, Saqeshima J, et al. Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med 2011;17:952-60.
27. Morath C, Wei C, Macher-Goeppinger S, Schwenger V, Zeimer M, Reiser J. Management of severe recurrent focal segmental glomerulosclerosis through circulating soluble urokinase receptor modification. Am J Ther 2013;20:226-9.
28. Backes Y, Sluijs KF, Tuip be Boer AM, Hofstra JJ, Vlaar AP, Determann RM, et al. Soluble urokinase-type plasminogen activator receptor levels in patients with burn injuries and inhalation trauma requiring mechanical ventilation: an observational cohort study. Critical Care 2011;15:R270.
29. Zimmermann HW, Reuken PA, Koch A, Bartneck M, Adams DH, Trautwein C, et al. Soluble urokinase plasminogen activator receptor (suPAR) is compartmentally regulated in decompensated cirrhosis and indicates immune activation and short-term mortality. J Intern Med 2013 Feb 21(Epub ahead of print)
30. Mizukami IF, Faulkner NE, Gyetko MR, Sitrin RG, Todd RF 3rd. Enzyme-linked immuno-absorbent assay detection of a soluble form of urokinase plasminogen activator receptor in vivo. Blood 1995;86:203-11.
31. Koch A, Voigt S, Kruschinski C, Sanson E, Dückers H, Horn A, et al. Circulating soluble urokinase plasminogen activator receptor is stably elevated during the first week of treatment in the intensive care unit and predicts mortality in critically ill patients. Critical Care 2011;15:R63.
32. Donadello K, Scolletta S, Covajes C, Vincent JL. suPAR as a prognostic biomarker in sepsis. BMC Medicine 2012;10:2.
33. Pierraoks C, Vincent JL. Sepsis biomarkers: a review. Crit Care 2010;14:R15.
34. Hoenigl M, Raggam RB, Wagner J, Valentin T, Leitner E, Seeber K, et al. Diagnostic accuracy of soluble urokinase plasminogen activator receptor (suPAR) for prediction of bacteremia in patients with systemic inflammatory response syndrome. Clin. Biochem 2013;46:225-9.
35. Kofoed K, Anderson O, Kronborg G, Tvede M, Petersen J, Eugen-Olsen J, et al. Use of plasma C-reactive protein, procalcitonin, neutrophils, macrophage migration inhibitory factor, soluble urokinase-type plasminogen activator receptor and soluble triggering receptor expressed on myeloid cells-1 in combination to diagnose infections: a prospective study. Crit Care 2007;11:R38
36. Roldan AL, Cubellis MV, Masucci MT, Behrendt N, Lund LR, Danø K, et al. Cloning and expresion of the receptor for human urokinase plasminogen activator, a central molecule in cell surface, plasmin dependent proteolysis. EMBO J 1990;9:467-74.
37. Seppala RU, Huttunen R, Tarkka M, Aittoniemş J, Koskinen P, Leino A, et al. Soluble urokinase-type plasminogen activator receptor in patients with suspected infection in the emergency room: a prospective cohort study. J Intern Med 2012;272:247-56.
38. Kofoed K, Eugen-Olsen J, Peterson J, Larsen K, Andersen O. Predicting mortality in patients with systemic inflammatory response syndrome: an evaluation of two prognostic models, two soluble receptors and a macrophage migration inhibitory factor. Eur J Clin Microbiol Infect Dis 2008;27:375-83.
39. Giamarellos-Bourboulis EJ, Norrby- Teglund A, Mylona V, Savva A, Tsangaris I, Dimopoulou I, et al. Risk assessment in sepsis: a new prognostication rule by APACHE II score and serum soluble urokinase plasminogen activator receptor. Critical Care 2012;16:R149.
40. Vincent JL, Opal SM, Marshall JC, Tracey KJ. Sepsis definitions: time for change. Lancet 2013;381:774-5.

APA	Bilgili B, Cinel I (2013). Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. , 33 - 39.
Chicago	Bilgili Beliz,Cinel Ismail Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. (2013): 33 - 39.
MLA	Bilgili Beliz,Cinel Ismail Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. , 2013, ss.33 - 39.
AMA	Bilgili B,Cinel I Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. . 2013; 33 - 39.
Vancouver	Bilgili B,Cinel I Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. . 2013; 33 - 39.
IEEE	Bilgili B,Cinel I "Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi." , ss.33 - 39, 2013.
ISNAD	Bilgili, Beliz - Cinel, Ismail. "Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi". (2013), 33-39.

APA	Bilgili B, Cinel I (2013). Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. Türk Yoğun Bakım Dergisi, 11(1), 33 - 39.
Chicago	Bilgili Beliz,Cinel Ismail Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. Türk Yoğun Bakım Dergisi 11, no.1 (2013): 33 - 39.
MLA	Bilgili Beliz,Cinel Ismail Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. Türk Yoğun Bakım Dergisi, vol.11, no.1, 2013, ss.33 - 39.
AMA	Bilgili B,Cinel I Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. Türk Yoğun Bakım Dergisi. 2013; 11(1): 33 - 39.
Vancouver	Bilgili B,Cinel I Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi. Türk Yoğun Bakım Dergisi. 2013; 11(1): 33 - 39.
IEEE	Bilgili B,Cinel I "Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi." Türk Yoğun Bakım Dergisi, 11, ss.33 - 39, 2013.
ISNAD	Bilgili, Beliz - Cinel, Ismail. "Yoğun bakım hastalarında soluble urokinase plasminogen activator receptor (suPAR)'ın önemi". Türk Yoğun Bakım Dergisi 11/1 (2013), 33-39.