The role of osteopontin in children with systemic inflammatory response syndrome and sepsis

Introduction: Sepsis is a leading cause of morbidity and mortality in critically ill children despite the use of modern antibiotics and resuscitation therapies. Sepsis must be distinguished from non-infection systemic inflammatory response syndrome (SIRS) induced by agents such as trauma and ischemia causing extensive tissue injury to establish appropriate treatments in critically ill patients. Osteopontin acts as an extracellular matrix component or soluble cytokine in inflamed tissues. Its exact role in immune response and sepsis remains to be elucidated. Objective: This study investigated the level of osteopontin in SIRS and sepsis to assess its involvement in the acute inflammatory diseases and its possible role as a marker differentiating children with SIRS from those with sepsis. Methods: Prospective, observational study at pediatric ICU at the children's Hospital, Zagazig University, Egypt, from October 2013 to December 2014. Forty-four patients with SIRS or sepsis and 44 healthy subjects were enrolled. All the children were subjected to detailed medical history, Clinical examination, laboratory estimation for CBC, blood cultures, serum osteopontin and IL-6 determination was performed by sandwich enzyme immunoassay technique. Results: Serum osteopontin levels were significantly higher in patients than in controls and in sepsis than in SIRS, and decreased during the resolution of both the disorders. A receiver operating characteristic curve identified that osteopontin level of 1040 ng/ml has discriminative power between SIRS and sepsis patients with 82.6% sensitivity and 70.4% specificity, area under curve was 0.833. Osteopontin levels directly correlated interleukin-6 levels and clinical severity scores. Conclusion: Osteopontin is strongly up-regulated during SIRS and sepsis and correlate with IL6 and clinical severity scores.