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 plasm a of critically ill patients and to compare it with the classic short pentr axin 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 Ba sel. Patients: A total of 101 consecutive critically ill patients admitted to th e medical ICU. Interventions: Venous blood samples were routinely obtained at entry, on da y 2, and at discharge or before death. Measurements and Main Results: Plasma samples were obtained from 101 consec utive critically ill patients admitted to the ICU with systemic inflammator y response syndrome, sepsis, or septic shock. PTX3 plasma levels were measu red by enzyme-linked immunosorbent assay. PTX3 was elevated in critically i ll patients, with a gradient from systemic inflammatory response syndrome t o septic shock. PTX3 levels correlated with clinical scores reflecting seve rity of disease (e.g., Acute Physiology and Chronic Health Evaluation II: p = .00097), In addition, high levels of PTX3 were associated with unfavorab le outcome. Conclusions: The long pentraxin PTX3 is elevated in critically ill patients and correlates with severity of disease and infection. Compared with the s hort pentraxin C-reactive protein, PTX3 may be a more direct indicator of t issue involvement by inflammatory and infectious processes.