An Italian multicentre study, in which Humanitas also participated, confirms the role of Pentraxin3, a protein known as PTX3, in a large number of patients as an indicator of the risk of complications and mortality in patients affected by sepsis. The work has involved the collaboration of the Humanitas Clinical Institute, the Mario Negri Institute for Pharmacological Research, with the contribution of Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico of the University of Milan, as the coordinating center of the ALBIOS study.

The study, selected from five finalists, received the ESCI – European Society of Clinical Investigation 2018 award in Barcelona for best work published in the field of clinical research.


The role of PTX3 and the results of the study

For several years, researchers have been working to obtain confirmation of the role of Pentraxin3 in detecting the risk of complications and mortality in patients with sepsis, a generalized infection of the entire body due to the entry of bacteria into the bloodstream.

As Barbara Bottazzi, Principal Investigator of the Immunopharmacology Laboratory of Humanitas, explains: “We had already seen the correlation between higher risk of mortality and higher levels of PTX3 in the blood in the heart attack. This study, conducted in 958 patients admitted for severe sepsis to various intensive care units, confirms the role of PTX3 as an indicator of diagnosis and prognosis. The time for use in real life will still be long, but this study opens the door to a possible use of PTX3 as an indicator of severity in patients with sepsis.

“The results of the study – added Roberto Latini, Head of the Cardiovascular Research Department of the IRCCS Mario Negri Pharmacological Research Institute – conducted on a part of the patients of the ALBIOS study have demonstrated the validity of PTX3 as a prognostic indicator. We found that high levels of PTX3 at day 1 were associated with increased patient severity (septic shock) and were able to predict the onset of serious complications in the cardiovascular, coagulative and renal systems. As a result, a smaller reduction in PTX3 levels over time was associated with an increased risk of patient mortality.

“This, for the physician, will mean being able to early assess the risk of the septic patient to face serious complications for which there are still few therapeutic weapons, such as the impairment of the coagulation system,” concluded Pietro Caironi, Department of Anesthesia-Rehabilitation and Emergency, Fondazione IRCCS Ca ‘Granda Policlinico di Milano.


The ALBIOS study

The researchers used part of the data of 1,818 patients from the ALBIOS study (designed and conducted by Professor Luciano Gattinoni to compare rehydration treatment protocols in septic patients) hospitalized for severe sepsis or septic shock in one hundred Italian intensive care units. PTX3 levels were measured in a subpopulation of 958 patients one, two, and seven days after hospitalization.


Sepsis in the world

Sepsis, a general infection of the whole organism due to the entry of bacteria into the bloodstream, kills ten times more than a heart attack and five times more than a stroke. The data reported every year on World Sepsis Day (13 September) show that infections, often considered complications, are the leading cause of death in a large number of patients. Every year, 31 million and 500 thousand people around the world develop sepsis, patients who often arrive at the emergency room in conditions that are already very serious, and 5 million and 300 thousand die every year.