Plasma level of TNF related apoptosis inducing ligand is associated with severity of disease in patients with sepsis and septic shock

Abstract

Recent studies have reported that necroptosis, a programmed necrosis mechanism, is involved in the pathogenesis and outcomes of sepsis. Tumor necrosis factor related apoptosis inducing ligand (TRAIL) is not only a key inducer of apoptosis but also a trigger for necroptosis.

The aim of this study was to assess the plasma level of TRAIL in patients with sepsis and septic shock and to determine the correlation between the level of TRAIL and severity of illness and mortality.

We retrospective analyzed the prospectively collected data of 190 critically ill patients enrolled in the intensive care unit (ICU) registry of Samsung Medical Center. TRAIL was measured from plasm of each patient collected on the day of ICU admission.

Of 190 critically ill patients, 59 (31.1%) and 84 (44.2%) patients were diagnosed with sepsis and septic shock, respectively. There was a trend of decrease in plasma level of TRAIL across the groups of control, sepsis, and septic shock (52.00 pg/mL vs. 35.83 pg/mL vs. 26.08 pg/mL, P < 0.001) When 143 patients with sepsis were classified into groups of high and low plasma TRAIL, lactic acid, SAPS 3 score, and SOFA score were significantly higher in the group of low plasma TRAIL. However, 28-day ICU mortality, in-hospital mortality, and 90-day mortality did not differ between the two groups. The area under the receiver operating characteristic curve for 28-day ICU mortality and in-hospital mortality according to plasma TRAL were 0.562 and 0.488, respectively.

Plasma level of TRAIL was associated with severity of sepsis in patients with sepsis and septic shock, however, not predictive of mortality.