Startseite Thrombopoietin levels in sepsis and septic shock – a systematic review and meta-analysis
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Thrombopoietin levels in sepsis and septic shock – a systematic review and meta-analysis

  • Chang Liu , Dennis Görlich , Clifford A. Lowell , Joseph E. Italiano , Jan Rossaint , Markus Bender , Alexander Zarbock und Andreas Margraf ORCID logo EMAIL logo
Veröffentlicht/Copyright: 1. Dezember 2023
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 62 Heft 5

Abstract

Objectives

Sepsis is a life-threatening condition implicating an inadequate activation of the immune system. Platelets act as modulators and contributors to immune processes. Indeed, altered platelet turnover, thrombotic events, and changes in thrombopoietin levels in systemic inflammation have been reported, but thrombopoietin-levels in sepsis and septic-shock have not yet been systematically evaluated. We therefore performed a meta-analysis of thrombopoietin (TPO)-levels in patients with sepsis.

Methods

Two independent reviewers screened records and full-text articles for inclusion. Scientific databases were searched for studies examining thrombopoietin levels in adult sepsis and septic-shock patients until August 1st 2022.

Results

Of 95 items screened, six studies met the inclusion criteria, including 598 subjects. Both sepsis and severe sepsis were associated with increased levels of thrombopoietin (sepsis vs. control: standardized mean difference 3.06, 95 % CI 1.35–4.77; Z=3.50, p=0.0005) (sepsis vs. severe sepsis: standardized mean difference −1.67, 95 % CI −2.46 to −0.88; Z=4.14, p<0.0001). TPO-levels did not show significant differences between severe sepsis and septic shock patients but differed between sepsis and inflammation-associated non-septic controls. Overall, high heterogeneity and low sample size could be noted.

Conclusions

Concluding, increased levels of thrombopoietin appear to be present both in sepsis and severe sepsis with high heterogeneity but thrombopoietin does not allow to differentiate between severe sepsis and septic-shock. TPO may potentially serve to differentiate sepsis from non-septic trauma and/or tissue damage related (systemic) inflammation. Usage of different assays and high heterogeneity demand standardization of methods and further large multicenter trials.

Keywords: sepsis; thrombopoietin; inflammation
Corresponding author: Dr. med. Andreas Margraf, Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, Münster, Germany; and Centre for Biochemical Pharmacology, William Harvey Research Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, EC1M 6BQ London, UK, Phone: (+49)251/83 46841, Fax: (+49)251/83 48667, E-mail:

Funding source: Deutsche Forschungsgemeinschaft

Award Identifier / Grant number: KFO 342, MA9604/1-1, MA9604/2-1, RO4537/4-1, RO4537/5-1, ZA428/18-1

Funding source: IZKF Münster

Award Identifier / Grant number: SEED 12/18

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: CL, AM screened literature. CL, AM performed data assessment and calculations. DG acted as statistical consultant. CL contributed to writing the manuscript. CAL, JR, MB, JEI, DG, AZ gave crucial input and contributed to writing the manuscript. AM conceived of and supervised the study, wrote the manuscript. All authors revised and approved the final version of the manuscript, accept responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: This study was supported by the Interdisciplinary Center for Clinical Research (IZKF, SEED 12/18 to A.M.) and the DFG (KFO342, RO4537/4-1 and RO4537/5-1 to J.R., ZA428/18-1 to A.Z. and MA9604/1-1 and MA9604/2-1 to A.M.). The funding organizations played no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the report for publication.

  6. Data availability: Data generated or analysed during this study are included in this published article and its supplementary information files (compare Supplementary File 1: Summary of Data Table).

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/cclm-2023-0792).

Received: 2023-07-25
Accepted: 2023-11-17
Published Online: 2023-12-01
Published in Print: 2024-04-25

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2023-0792
Schlagwörter für diesen Artikel
sepsis; thrombopoietin; inflammation

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. The International Consensus on ANA Patterns (ICAP): from conception to implementation
  4. Review
  5. Machine learning-based clinical decision support using laboratory data
  6. Mini Review
  7. Standardisation and harmonisation of thyroid-stimulating hormone measurements: historical, current, and future perspectives
  8. Opinion Papers
  9. Adopting the International Consensus on ANA Patterns (ICAP) classification for reporting: the experience of Italian clinical laboratories
  10. Rising adoption of artificial intelligence in scientific publishing: evaluating the role, risks, and ethical implications in paper drafting and review process
  11. Biological variation of inflammatory and iron metabolism markers in high-endurance recreational athletes; are these markers useful for athlete monitoring?
  12. General Clinical Chemistry and Laboratory Medicine
  13. A model for managing quality control for a network of clinical chemistry instruments measuring the same analyte
  14. Impact of Academia-Government Collaboration on Laboratory Medicine Standardization in South Korea: analysis of eight years creatinine proficiency testing experience
  15. Measurement uncertainty estimation of free drug concentrations in clinical laboratories using equilibrium dialysis
  16. Use of dried blood spots for monitoring inflammatory and nutritional biomarkers in the elderly
  17. S100B vs. “GFAP and UCH-L1” assays in the management of mTBI patients
  18. Evaluation of five multisteroid LC‒MS/MS methods used for routine clinical analysis: comparable performance was obtained for nine analytes
  19. Ensuring quality in 17OHP mass spectrometry measurement: an international study assessing isomeric steroid interference
  20. A novel LC-MS/MS-based assay for the simultaneous quantification of aldosterone-related steroids in human urine
  21. Clinical specificity of two assays for immunoglobulin kappa and lambda free light chains
  22. Reference Values and Biological Variations
  23. Estimation of the reference values and decision limits for growth hormone in newborns using dried blood spots
  24. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population
  25. Hematology and Coagulation
  26. Detection of blasts using flags and cell population data rules on Beckman Coulter DxH 900 hematology analyzer in patients with hematologic diseases
  27. Cancer Diagnostics
  28. Drainage fluid LDH and neutrophil to lymphocyte ratio as biomarkers for early detecting anastomotic leakage in patients undergoing colorectal surgery
  29. Cardiovascular Diseases
  30. Performance evaluation of a novel high-sensitivity cardiac troponin T assay: analytical and clinical perspectives
  31. Diabetes
  32. Ferric particle-assisted LDI-MS platform for metabolic fingerprinting of diabetic retinopathy
  33. Infectious Diseases
  34. Thrombopoietin levels in sepsis and septic shock – a systematic review and meta-analysis
  35. Effect of temperature on presepsin pre-analytical stability in biological fluids of preterm and term newborns
  36. Letters to the Editor
  37. Pseudohyperglycemia due to glucometer interference in galactosemia
  38. What could cause a false increase in serum C-reactive protein concentration?
  39. Discriminating signal from noise: the biological variation of circulating calprotectin in serum and plasma
  40. Diagnostic accuracy of adenosine deaminase for tuberculous pleural effusion: age does matter
  41. The role of the Brazilian proficiency testing/External Quality Assessment Program in the improvement of glycated hemoglobin measurement
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