LEVELS OF SOLUBLE FC-GAMMA-RIII CORRELATE WITH DISEASE SEVERITY IN SEPSIS

Neutrophil activation is thought to play a crucial role in the pathoge nesis of sepsis. During activation, neutrophils adhere to and migrate through the endothelium. Therefore, the amount of circulating neutroph ils does not adequately reflect the total amount of neutrophils that a re involved in the pathophysiologic process of this condition. In this study we test the hypothesis that the severity of sepsis is associate d with the total body mass of neutrophils as reflected in the plasma c oncentration of soluble Fc gamma receptor type III (sFc gamma RIII). N ineteen patients with sepsis (12 male, seven female, median age of 69 years, range 29-87 years) were included in this study. Ten healthy vol unteers served as controls. Plasma sFc gamma RIII concentrations were measured by ELISA. Other parameters that were studied were leucocyte c ount, plasma concentrations of lactoferrin and soluble L-selectin, and surface expression of CD11b and CD66b on circulating neutrophils. Dis ease activity was measured using the Acute Physiology and Chronic Heal th Evaluation (APACHE) II score. Soluble Fc gamma RIII levels were ele vated in sepsis patients whereas soluble L-selectin levels were modera tely decreased compared with healthy controls. Markers of cell activat ion were significantly increased in sepsis patients. Soluble Fc gamma RIII correlated with disease severity as measured by the APACHE score (P < 0.05, r = 0.53), whereas the other parameters did not correlate w ith the APACHE score. In conclusion, this study demonstrates that solu ble Fc gamma RIII is a useful marker for disease severity in patients with sepsis.