Apolipoprotein A1 and serum amyloid A in dogs with sepsis and septic shock.

Abstract

INTRODUCTION: Apolipoprotein-A1 (Apo-A1) acts as a negative acute phase protein (APP) during inflammatory states, and has a potential prognostic value in people and dogs with sepsis. The aim of this retrospective study was to investigate the association of serum Apo-A1 concentration with disease severity, multiorgan dysfunction syndrome (MODS) and outcome in a population of dogs with sepsis, and to assess its correlation with major canine APPs. METHODS: Ninety-nine dogs with uncomplicated sepsis (= 78) or septic shock (= 21) were included. The serum concentration of Apo-A1, C-reactive protein (CRP) and serum amyloid A (SAA) were recorded, alongside the canine acute patient physiologic and laboratory evaluation fast (APPLE) score and the presence of MODS. RESULTS: Dogs with septic shock had significantly lower serum Apo-A1 concentrations (106.3 &#xb1; 22.7 mg/dl; reference interval: 123.0-142.3 mg/dl), higher APPLEscore (30, 13-38) and greater frequency of MODS (67%) compared to those with uncomplicated sepsis (117.9 &#xb1; 19.3 mg/dl; 25, 6-33 and 8%, respectively) (= 0.0201;= 0.0005; P < 0.0001, respectively). Similarly, dogs with MODS had significantly lower serum Apo-A1 concentrations (104.1 &#xb1; 4.6 mg/dl) and higher APPLEscore values (31, 13-38) compared to those without MODS (118.32 &#xb1; 2.1 mg/dl and 26, 6-33, respectively) (= 0.0050 and= 0.0038, respectively). Conversely, neither CRP nor SAA were different between these groups. No difference in serum APPs concentrations was detected between survivors and non-survivors. Significant negative correlations were detected between serum Apo-A1 and SAA (= 0.0056,= -0.277), and between serum Apo-A1 and the APPLEscore (= 0.0027,= -0.3). In this population, higher values of the APPLEscore and the presence of MODS were independently associated with a higher risk of death. DISCUSSION: Our study shows that Apo-A1 is a useful biomarker of sepsis severity in dogs, since it is decreased in those with septic shock and MODS. Further prospective investigations are deemed to evaluate the applicability of Apo-A1 to predict sepsis course and response to treatment in septic dogs.