Early Diagnosis of Sepsis Using Serum Hemoglobin Subunit Beta

The development of new sepsis-specific biomarkers is mandatory to improve the detection and monitoring of the disease. Hemoglobin is the main oxygen and carbon dioxide carrier in cells of the erythroid lineage and is responsible for oxygen delivery to the respiring tissues of the body. Hemoglobin subunit beta (HB beta) is a component of a larger protein called hemoglobin. The aim of this study was to evaluate blood levels of HB beta in septic patients. A prospective study of 82 patients with sepsis was conducted. Furthermore, C57BL/6 mice were subjected to cecal ligation and puncture (CLP) surgery. Alternatively, human umbilical vein endothelial cells (HUVECs) or C57BL/6 mice were exposed to lipopolysaccharide (LPS, 100 ng/ml to HUVECs or 10 mg/kg to mice). The data showed that LPS induced upregulation of the synthesis and secretion of HB beta in LPS-treated HUVECs and in LPS-injected and CLP mice. In patients admitted to the intensive care unit with sepsis, circulating levels of HB beta were significantly high (sepsis, 64.93-114.76 ng/ml, n = 30; severe sepsis, 157.37-268.69 ng/ml, n = 22; septic shock, 309.98-427.03 ng/ml, n = 30) when compared to the levels of control donors (9.76-12.28 ng/ml, n = 21). Patients with septic shock had higher HB beta levels when compared to patients with severe sepsis. Furthermore, the HB beta levels in septic patients were higher than those in healthy volunteers. These results suggest that in septic patients, HB beta blood level is related to the severity of sepsis and may represent a novel endothelial cell dysfunction marker. Moreover, HB beta can be used as a biomarker to determine the severity of sepsis.