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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objective To assess the role of serum levels of stromal-derived-factor 1 and its receptor α-chemokine receptor type 4 (CXCR4) as reliable markers for diagnosis of sepsis in the emergency department. Background Pediatric sepsis is a major cause of morbidity and mortality in children admitted to the pediatric ICU. The chemokine CXCL12 and its receptor CXCR4 are now known to play an important role in inflammatory states and mediate lymphocyte migration. Patients and methods In a prospective cohort study, we randomly enrolled 23 critically ill children admitted into pediatric ICU, and 15 healthy children served as controls. Serum levels of CXCL12 and lymphocyte expression of CXCR4 were measured for patients as well as control by enzyme-linked immunosorbent assay technique and flow cytometry, respectively. Results Serum levels of CXCL12 and lymphocytes expression levels of CXCR4 were significantly higher among the all patients with sepsis compared with controls (P < 0.001). The diagnostic accuracy of CXCL12 in diagnosis of pediatric sepsis was 92.1%, with a sensitivity 100% and a specificity 80% at a cutoff point 89.3 pg/ml, whereas the diagnostic accuracy of mean fluorescent intensity of lymphocyte expression of CXCR4 was 92.1%, with sensitivity 95.6%, specificity 86.7%, at cutoff point of 120.2%. Furthermore, serum level of CXCL12 and CXCR4 expression were significantly elevated in nonsurvived compared with survived patients (P < 0.001). Conclusion Overall, the data support the view that measurements of serum CXCL12 and CXCR4 expression result in substantial added value for early diagnosis and prognosis of pediatric sepsis.

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