High levels of soluble neuropilin-1 in critically ill multiple trauma/surgical patients.

PURPOSE: Critically ill trauma/surgical patients may experience excessive inflammation, immune and coagulation dysregulation, leading to multiple organ failure (MOF), carrying high mortality rates. Neuropilin-1 (NRP-1) and its soluble isoform (sNRP-1) are implicated in immune response regulation, inflammation, and vascular permeability. This study aimed to investigate the possible role of sNRP-1 in trauma/surgical patients in the intensive care unit (ICU).

PATIENTS AND

METHODS

This prospective observational study was conducted in a 31-bed ICU and included 81 patients, 43 of whom were trauma/surgical patients and 38 of whom were matched medical patients, comprising the control group. sNRP-1, interleukin (IL)-6, IL-8, and IL-10 levels were measured on admission to the ICU (within 48 ​h).

RESULTS

Trauma/surgical patients had significantly higher sNRP-1 (p ​= ​0.027), IL-6, IL-8, and IL-10 levels (p ​< ​0.05) compared to medical patients. In the entire cohort, sNRP-1 correlated positively with the international normalized ratio (INR) (p ​= ​0.017), the activated partial thromboplastin time (p ​= ​0.026), fibrinogen (p ​= ​0.027), alanine aminotransferase (p ​= ​0.024), and C-reactive protein (p ​= ​0.004). Moreover, sNRP-1 correlated negatively with total protein (p ​= ​0.035), albumin (p ​= ​0.005), and platelets (p ​= ​0.033).

CONCLUSION

sNRP-1 levels were elevated in critically ill trauma/surgical patients compared to matched medical ICU patients. Further research is needed to elucidate the exact role of sNRP-1 in these patients' pathophysiology.