GLYCOSYLATION OF ALPHA(1)-ACID GLYCOPROTEIN IN SEPTIC SHOCK - CHANGESIN DEGREE OF BRANCHING AND IN EXPRESSION OF SIALYL LEWIS(X) GROUPS

The occurrence of differences in acute-phase response, with respect to concentration and glycosylation of alpha(1)-acid glycoprotein (AGP) w as studied in the sera of patients surviving or not from septic shock. Crossed affino-immunoelectrophoresis was used with concanavalin A and Aleuria aurantia lectin for the detection of the degree of branching and fucosylation, respectively, and the monoclonal CSLEX-1 for the det ection of sialyl Lewis(x) (SLeX) groups on AGP. Septic shock apparentl y induced an acute-phase response as indicated by the increased serum levels and changed glycosylation of AGP. In the survivor group a trans ient increase in diantennary glycan content was accompanied by a gradu ally increasing fucosylation and SLeX expression, comparable to those observed in the early phase of an acute-inflammatory response. Remarka bly, in the non-survivor group a modest increase in diantennary glycan content was accompanied by a strong elevation of the fucosylation of AGP and the expression of SLeX groups on AGP, typical for the late pha se of an acute-phase response. Our results suggest that these changes in glycosylation of AGP can have a prognostic value for the outcome of septic shock.