Changes of histidine-rich glycoprotein levels in critically ill septic patients

Abstract

Abstract Histidine-rich glycoprotein (HRG) has been reported as a prognostic factor in patients with sepsis. However, the relevance of HRG to the pathogenesis of septic-induced shock, disseminated intravascular coagulopathy (DIC), and acute respiratory distress syndrome (ARDS) is unknown. In 53 critically ill patients, we examined the association between HRG concentrations and the pathogenesis of these conditions. Serum HRG concentrations were significantly lower on days 3, 5, and 7 than on day 1 in patients with septic shock and in those with DIC, but not in those with ARDS. Although HRG concentrations on day 1 were not associated with survival, HRG concentrations were decreased in non-survivors, with a significant decline on days 3, 5, and 7 after admission to the intensive care unit. Whereas, HRG concentrations did not change in survivors. Decreased HRG concentrations may independently play a role in the pathogenesis of DIC in patients with sepsis and may relate to DIC-related mortality. A progressive decrease in HRG concentrations, especially on days 5 and 7, may affect the mortality rate. Therefore, supplemental HRG treatment may become a new strategy for critically ill patients with sepsis.