Circulating levels of the long pentraxin PTX3 correlate with severity of infection in critically ill patients

Objective: To evaluate the recently discovered long pentraxin PTX3 in plasma of critically ill patients and to compare it with the classic short pentraxin C-reactive protein and with other indicators of inflammation. Design: A cohort study on plasma samples. Setting: Medical intensive care unit (ICU) of the University Hospital of Basel. Patients: A total of 101 consecutive critically ill patients admitted to the medical ICU. Interventions: Venous blood samples were routinely obtained at entry, on day 2, and at discharge or before death. Measurements and Main Results: Plasma samples were obtained from 101 consecutive critically ill patients admitted to the ICU with systemic inflammatory response syndrome, sepsis, or septic shock. PTX3 plasma levels were measured by enzyme-linked immunosorbent assay. PTX3 was elevated in critically ill patients, with a gradient from systemic inflammatory response syndrome to septic shock. PTX3 levels correlated with clinical scores reflecting severity of disease (e.g., Acute Physiology and Chronic Health Evaluation II: p = .00097), In addition, high levels of PTX3 were associated with unfavorable outcome. Conclusions: The long pentraxin PTX3 is elevated in critically ill patients and correlates with severity of disease and infection. Compared with the short pentraxin C-reactive protein, PTX3 may be a more direct indicator of tissue involvement by inflammatory and infectious processes.