The dead cells still count

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Transplantation and Graft versus Host Disease

Graft-versus-host (GvHD) reactions occur, to a variable degree, in all recipients of allogeneic hematopoietic cell transplantations. A major clinical problem in the management of transplantation patients is the difficulty of distinguishing GvHD activity, a process that may be amenable to immunosuppressive treatment, from GvHD damage to various host tissues.

In a retrospective study published in Blood (2007), Luft and colleagues showed that plasma caspase-cleaved keratin 18 (referred to as Cytokeratin 18 Fragment, ”CK18F”, in the paper) is a sensitive and quantitative biomarker of hepatic and intestinal epithelial apoptosis caused by GvHD. CK18F was measured using the M30 Apoptosense® ELISA from PEVIVA.

References:
»   T. Luft et al., Serum cytokeratin-18 fragments as quantitative markers of epithelial apoptosis in liver and intestinal graft-versus-host disease, Blood 110: 4535-4542, 2007
»  

PJ. Martin, Cell biology comes to the bedside, Blood 110: 4135, 2007 (Editorial)

Sepsis

The clinical syndrome of sepsis encompasses a highly heterogeneous group of clinical disorders, varying with respect to the site, presence of infection and with the clinical syndrome evolving in the host.

The incidences of severe sepsis (sepsis associated with acute organ dysfunction) and septic shock (sepsis associated with cardiovascular compromise) are estimated to be between 300 000 and 750 000 cases each year. 

Hofer et al. studied 101 patients with severe sepsis. Caspase-cleaved and total K18 were found to be early predictors for survival in severe septic patients with hepatic dysfunction.

References:
»  
» Hofer et al., Cell death serum biomarkers are early predictors for survival in severe septic patients with hepatic dysfunction. Critical Care 2009, 13:R93.