Clinical significance and prognosis of serum tenascin-C in patients with sepsis

Background: Tenascin-C is a pro-inflammatory glycoprotein with various biological functions. High expression of tenascin-C is found in inflammation, tissue remodeling, and autoimmune diseases. However, its expression and clinical significance in sepsis remain unclear. This study was designed to investigate the relationship between serum tenascin-C levels and disease severity and prognosis in patients with sepsis. Methods: A total of 167 patients with sepsis admitted to the ICU were enrolled. Lood samples were collected within 24h of admission. Serum tenascin-C levels were measured by enzyme-linked immunosorbent assay (ELISA). Follow-up was performed to observe 30-day mortality. Results: Serum tenascin-C levels were significantly elevated in patients with sepsis compared with non-sepsis controls (P<0.001). Serum tenascin-C levels were higher in nonsurvivors (58 cases) who died within 30days (34.5%) compared to survivors (109 cases) (P<0.001). In patients with sepsis, serum tenascin-C levels were significantly positively correlated with SOFA scores (P=0.011), serum creatinine (P=0.006), C-reactive protein (CRP) (P=0.001), interleukin-6 (IL-6) (P<0.001), and tumor necrosis factor (TNF-alpha) (P=0.026). Logistic multivariate regression models showed that serum tenascin-C levels were independent contributor of 30-day mortality. Kaplan-Meier curves showed that septic patients with high levels of serum tenascin-C (>= 56.9 pg/mL) had significantly higher 30-day mortality than those with lower serum tenascin-C (<56.9pg/mL) (P<0.001). Conclusion: Elevated serum tenascin-C was found in septic patients and associated with severity and poor prognosis.