Sustained high serum caspase-3 concentrations and mortalityin septic patients

Abstract Caspase-3 is the main executor of the apoptoticprocess. Higher serum caspase-3 concentrations in nonsurvivorcompared to survivor septic patients have beenfound. The objectives of this work (with the increase of samplesize to 308 patients, and the determination of serumcaspase-3 concentrations also on days 4 and 8 of diagnosisof severe sepsis) were to know whether an association betweenserum caspase-3 concentrationss during the first week,degree of apoptosis, sepsis severity, and sepsis mortality exists.We collected serum samples of 308 patients with severesepsis from eight intensive care units on days 1, 4 and 8 tomeasure concentrations of caspase-3 and caspase-cleavedcytokeratin (CCCK)-18 (to assess degree of apoptosis). Endpoint was 30-day mortality. We found higher serum concentrationsof caspase-3 and CCCK-18 in non-survivors comparedto survivors on days 1 (p < 0.001), 4 (p < 0.001), and8 (p < 0.001). We found an association between serumcaspase-3 concentrations on days 1, 4 and 8 of severe sepsisdiagnosis and serum CCCK-18 concentrations (p < 0.001),SOFA (p < 0.001), serum acid lactic concentration