Change of hemopexin level is associated with the severity of sepsis in endotoxemic rat model and the outcome of septic patients

Purpose: The purpose of the study is to uncover the role of hemopexin (HPX) as anti- inflammatory mediator in animals and humans. Materials and methods: We injected rats with 5 and 10 mg/kg of lipopolysaccharide to induce low-and high-grade endotoxemia (LGE and HGE), respectively, and we measured serum levels of tumor necrosis factor alpha, interleukin 6, and HPX at 0, 1, 3, and 6 hours after the injection. In a clinical study, we measured the initial serum HPX concentrations of septic shock patients. We evaluated the correlation between HPX levels and sepsis severity in rats and the predictive value of the HPX level for 28-day mortality of patients. Results: In rats, serum interleukin 6 and tumor necrosis factor a concentrations were lower in LGE than in HGE, whereas the HPX level in HGE at 6 hours was significantly lower than in LGE (0.88, interquartile range [0.79-1.00] vs 1.33, interquartile range [1.29-1.49] mg/mL, P = .002). In patients, the initial serum HPX level in nonsurvivors was significantly lower than in survivors (0.75 vs 1.02 mg/mL, P<.001). Multivariate logistic regression analysis revealed that HPX exhibited independent prognostic value for 28-day mortality, and its levels were closely related to Acute Physiology and Chronic Health Evaluation II scores. Conclusions: Low serum HPX levels are related to sepsis severity and could indicate poor prognosis for septic shock patients. (C) 2014 Elsevier Inc. All rights reserved.