Affiliations: Department of Anesthesiology and Intensive Care
Medicine, University of Bonn Medical Center, Bonn, Germany | Department of Dermatology, Boston University Medical
Center, Boston, MA, USA
Note: [] Address for correspondence: Stefan Weber MD, DESA, Department of
Anesthesiology and Intensive Care Medicine, University of Bonn Medical Center,
Sigmund Freud Str. 25, 53127 Bonn, Germany. Tel.: +49 228 287 14114; Fax: +49
228 287 16754; E-mail: stefan.weber@ukb.uni-bonn.de
Abstract: During sepsis, a severe systemic disorder, micronutrients often are
decreased. Apoptosis is regarded as an important mechanism in the development
of often significant immunosuppression in the course of the disease. This study
aimed to investigate α-tocopherol and selenium in
reference to apoptosis in patients with sepsis. 16 patients were enrolled as
soon as they fulfilled the criteria of severe sepsis. 10 intensive care
patients without sepsis and 11 healthy volunteers served as controls.
α-Tocopherol, selenium and nucleosomes were measured
in serum. Phosphatidylserine externalization and Bcl-2 expression were analyzed
in T-cells by flow cytometry. Serum α-tocopherol and
selenium were decreased in severe sepsis but not in non-septic critically ill
patients (p < 0.05). Conversely, markers of apoptosis were
increased in sepsis but not in critically ill control patients: Nucleosomes
were found to be elevated 3 fold in serum (p < 0.05) and
phosphatidylserine was externalized on an expanded subpopulation of T-cells
(p < 0.05) while Bcl-2 was expressed at lower levels
(p < 0.05). The decrease of micronutrients correlated with
markers of accelerated apoptosis. Accelerated apoptosis in sepsis is associated
with low α-tocopherol and selenium. The results
support the investigation of micronutrient supplementation strategies in severe
sepsis.
