Bone Homeostasis Disorders Increased the Mortality of Sepsis Patients: A Preliminary Retrospective Cohort Study

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Dec 19

PMID 36530881

Authors

Dong Wang

Jingyi Wang

Xi Zheng

Shuo Diao

Wenxiong Li

Wenliang Ma

Affiliations

Soon will be listed here.

Abstract

Introduction: Sepsis is a common clinical syndrome and nearly 20% of all deaths are related to sepsis. As an important part of the body, bone homeostasis disorders are closely related to inflammatory response, but the correlation between bone homeostasis and sepsis, sepsis shock was unknown. The objective of this study was to explore the relation of bone homeostasis on sepsis and sepsis shock.

Methods: In this retrospective cohort study, patients were enrolled between April 2018 and May 2022 from Beijing Chaoyang hospital. Primary outcomes were serum indicators reflected bone homeostasis, such as cross-linked carboxy-terminal telopeptide of type I collagen (CTX-I), tartrate-resistant acid phosphatase 5b (TRACP-5b) and piezo-type mechanosensitive ion channel component 1 (PIEZO1).

Results: The data were analyzed retrospectively. among 88 evaluable patients, 45 were sepsis (19 were sepsis shock) and 43 were non-sepsis. There was no significant difference in age, gender, BMI, combination diseases, operation time, intraoperative blood loss, and hospital stay. Patients with sepsis or sepsis shock had higher serum CTX-I, TRACP-5b, PIEZO1 ( < 0.05). Spearman's rank correlation test showed that CTX-I, TRACP-5b, PIEZO1 and the three together (CTX-I + TRACP-5b + PIEZO1) had strong correlation with sepsis or sepsis shock ( < 0.05). The receiver operating characteristic curve (ROC) and precision-recall curve (PRC) showed that these indicators could predict the occurrence of sepsis or sepsis shock ( < 0.05). Besides, decision curve analysis (DCA) and interventions avoided curve (IAC) displayed a high net benefit of bone homeostasis disorders indicators on sepsis or sepsis shock. Kaplan-Meier survival curves revealed that sepsis or shock patients with high value indicators (>0.47227) had a higher mortality ( < 0.05).

Conclusion: Bone homeostasis disorders could increase the mortality of sepsis and sepsis shock patients.

References

Kjorholt K, Kristensen N, Prieto-Alhambra D, Johnsen S, Pedersen A . Increased risk of mortality after postoperative infection in hip fracture patients. Bone. 2019; 127:563-570. DOI: 10.1016/j.bone.2019.07.023. View

Wang L, You X, Lotinun S, Zhang L, Wu N, Zou W . Mechanical sensing protein PIEZO1 regulates bone homeostasis via osteoblast-osteoclast crosstalk. Nat Commun. 2020; 11(1):282. PMC: 6962448. DOI: 10.1038/s41467-019-14146-6. View

Otto E, Knapstein P, Jahn D, Appelt J, Frosch K, Tsitsilonis S . Crosstalk of Brain and Bone-Clinical Observations and Their Molecular Bases. Int J Mol Sci. 2020; 21(14). PMC: 7404044. DOI: 10.3390/ijms21144946. View

Jeong H, Kim D . Bone Diseases in Patients with Chronic Liver Disease. Int J Mol Sci. 2019; 20(17). PMC: 6747370. DOI: 10.3390/ijms20174270. View

Venet F, Monneret G . Advances in the understanding and treatment of sepsis-induced immunosuppression. Nat Rev Nephrol. 2017; 14(2):121-137. DOI: 10.1038/nrneph.2017.165. View

Guder C, Gravius S, Burger C, Wirtz D, Schildberg F . Osteoimmunology: A Current Update of the Interplay Between Bone and the Immune System. Front Immunol. 2020; 11:58. PMC: 7004969. DOI: 10.3389/fimmu.2020.00058. View

Kusumbe A, Ramasamy S, Adams R . Coupling of angiogenesis and osteogenesis by a specific vessel subtype in bone. Nature. 2014; 507(7492):323-328. PMC: 4943525. DOI: 10.1038/nature13145. View

Bayer J, Vaghela R, Drechsler S, Osuchowski M, Erben R, Andrukhova O . The bone is the major source of high circulating intact fibroblast growth factor-23 in acute murine polymicrobial sepsis induced by cecum ligation puncture. PLoS One. 2021; 16(5):e0251317. PMC: 8121358. DOI: 10.1371/journal.pone.0251317. View

Hagel S, Bach F, Brenner T, Bracht H, Brinkmann A, Annecke T . Effect of therapeutic drug monitoring-based dose optimization of piperacillin/tazobactam on sepsis-related organ dysfunction in patients with sepsis: a randomized controlled trial. Intensive Care Med. 2022; 48(3):311-321. PMC: 8866359. DOI: 10.1007/s00134-021-06609-6. View

10.

Moskowitz A, Huang D, Hou P, Gong J, Doshi P, Grossestreuer A . Effect of Ascorbic Acid, Corticosteroids, and Thiamine on Organ Injury in Septic Shock: The ACTS Randomized Clinical Trial. JAMA. 2020; 324(7):642-650. PMC: 7435341. DOI: 10.1001/jama.2020.11946. View

11.

Aykut B, Chen R, Kim J, Wu D, Shadaloey S, Abengozar R . Targeting Piezo1 unleashes innate immunity against cancer and infectious disease. Sci Immunol. 2020; 5(50). DOI: 10.1126/sciimmunol.abb5168. View

12.

Tsukasaki M, Takayanagi H . Osteoimmunology: evolving concepts in bone-immune interactions in health and disease. Nat Rev Immunol. 2019; 19(10):626-642. DOI: 10.1038/s41577-019-0178-8. View

13.

Eick G, Devlin M, Cepon-Robins T, Kowal P, Sugiyama L, Josh Snodgrass J . A dried blood spot-based method to measure levels of tartrate-resistant acid phosphatase 5b (TRACP-5b), a marker of bone resorption. Am J Hum Biol. 2019; 31(3):e23240. DOI: 10.1002/ajhb.23240. View

14.

Scheer C, Kuhn S, Fuchs C, Vollmer M, Modler A, Brunkhorst F . Do Sepsis-3 Criteria Facilitate Earlier Recognition of Sepsis and Septic Shock? A Retrospective Cohort Study. Shock. 2018; 51(3):306-311. DOI: 10.1097/SHK.0000000000001177. View

15.

Zhao Y, Feng X, Li B, Sha J, Wang C, Yang T . Dexmedetomidine Protects Against Lipopolysaccharide-Induced Acute Kidney Injury by Enhancing Autophagy Through Inhibition of the PI3K/AKT/mTOR Pathway. Front Pharmacol. 2020; 11:128. PMC: 7052304. DOI: 10.3389/fphar.2020.00128. View

16.

Han S, Kim N, Kang J, Eun J, Kang Y . Radial BMD and serum CTX-I can predict the progression of carotid plaque in rheumatoid arthritis: a 3-year prospective cohort study. Arthritis Res Ther. 2021; 23(1):258. PMC: 8513174. DOI: 10.1186/s13075-021-02642-4. View

17.

Cannata-Andia J, Martin-Carro B, Martin-Virgala J, Rodriguez-Carrio J, Bande-Fernandez J, Alonso-Montes C . Chronic Kidney Disease-Mineral and Bone Disorders: Pathogenesis and Management. Calcif Tissue Int. 2020; 108(4):410-422. DOI: 10.1007/s00223-020-00777-1. View

18.

Yang N, Liu Y . The Role of the Immune Microenvironment in Bone Regeneration. Int J Med Sci. 2021; 18(16):3697-3707. PMC: 8579305. DOI: 10.7150/ijms.61080. View

19.

Garbero E, Livigni S, Ferrari F, Finazzi S, Langer M, Malacarne P . High dose coupled plasma filtration and adsorption in septic shock patients. Results of the COMPACT-2: a multicentre, adaptive, randomised clinical trial. Intensive Care Med. 2021; 47(11):1303-1311. DOI: 10.1007/s00134-021-06501-3. View

20.

Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M . The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-10. PMC: 4968574. DOI: 10.1001/jama.2016.0287. View