Detection of lysophosphatidylcholine for prognosis or diagnosis of a systemic inflammatory condition

Abstract

The present invention provides methods and compositions useful for the diagnosis or prognosis of a systemic inflammatory condition such as sepsis.

1 . A method for the diagnosis or prognosis of a systemic inflammatory condition in a patient comprising the step of:
 measuring over time a plurality of amounts of a compound according to formula (I)   
       
         
           
           
               
               
           
         
         or a salt or solvate thereof, wherein R is C 16 -C 18  acyl, 
         in fluid or tissue of the patient to assess risk for the systemic inflammatory condition. 
       
     
     
         2 . The method of  claim 1  wherein a decreasing amount indicates diagnosis of the systemic inflammatory condition. 
     
     
         3 . The method of  claim 1  wherein the systemic inflammatory condition is selected from the group consisting of SIRS-positive, sepsis and septic shock. 
     
     
         4 . The method of  claim 1  wherein the patient is SIRS-positive. 
     
     
         5 . The method of  claim 1  wherein the amount is measured by spectrometry, chromatography, immunoassay, electrophoresis or enzymatic assay. 
     
     
         6 . The method of  claim 1  wherein the fluid or tissue is blood, plasma, saliva, serum, sputum, urine, cells, cellular extract or tissue biopsy. 
     
     
         7 . The method of  claim 1  further comprising the step of assessing risk for the systemic inflammatory condition from clinical data. 
     
     
         8 . The method of  claim 7  wherein the clinical data is selected from the group consisting of temperature, heart rate, white blood cell count, monocyte count, lymphocyte count, granulocyte count, neutrophil count, immature neutrophil to total neutrophil ratio, platelet count, serum creatinine concentration, urea concentration, lactate concentration, base excess, pO 2  and HCO 3   − . 
     
     
         9 . The method of  claim 1  further comprising the step of assessing risk for the systemic inflammatory condition from a clinical model for the systemic inflammatory condition. 
     
     
         10 . The method of  claim 9  wherein the clinical model is selected from the group consisting of the Acute Physiology and Chronic Health Evaluation, the Acute Physiology and Chronic Health Evaluation II, the Acute Physiology and Chronic Health Evaluation III, the Mortality Prediction Model, the Simplified Acute Physiology score, the Multiple Organ Dysfunction Score, the Sequential Organ Failure Assessment score, the Logistical Organ Dysfunction Score, and the predisposition, infection, response, and organ dysfunction concept. 
     
     
         11 . A method for the diagnosis or prognosis of a systemic inflammatory condition in a patient comprising the step of:
 comparing the amount of a compound according to formula (I)   
       
         
           
           
               
               
           
         
         or a salt or solvate thereof, wherein R is C 16 -C 18  acyl, 
         in fluid or tissue of the patient to a reference amount indicative of the amount of the compound in fluid or tissue of an individual that has, or will have, the systemic inflammatory condition to assess risk for the systemic inflammatory condition. 
       
     
     
         12 . The method of  claim 11  wherein the difference between the amounts correlates inversely with risk for the systemic inflammatory condition. 
     
     
         13 . The method of  claim 11  wherein the amount is measured 0, 12, 24, 36 or 48 hours prior to the onset of the systemic inflammatory condition. 
     
     
         14 . The method of  claim 11  wherein the individual is sepsis-positive. 
     
     
         15 . The method of  claim 11  wherein the patient is SIRS-positive. 
     
     
         16 . A kit diagnosis or prognosis, or monitoring, of a systemic inflammatory condition in a patient, said kit comprising
 an enzyme or reagent capable of reacting lysophosphatidylcholine to form glycerophosphatidylcholine,   an enzyme or reagent capable of reacting glycerophosphatidylcholine to form choline,   an enzyme or reagent capable of reacting choline, water and oxygen to form peroxide,   a peroxidase and   a fluorogenic substrate of said peroxidase.   
     
     
         17 . The kit of  claim 16  comprising lysophospholipase, a glycerophosphatidylcholine diesterase, a choline oxidase, a peroxidase and 10-acetyl-3,7-dihydroxyphenoxazine. 
     
     
         18 . The kit of  claim 16  comprising a EC 3.1.1.5, EC 3.1.4.2, EC 1.1.3.17, horseradish peroxidase and 10-acetyl-3,7-dihydroxyphenoxazine. 
     
     
         19 . A device for the diagnosis or prognosis of a systemic inflammatory condition wherein said device is capable of measuring the amount of a compound according to formula (I) 
       
         
           
           
               
               
           
         
         or a salt or solvate thereof, wherein R is C 16 -C 18  acyl, in fluid or tissue of the patient and wherein said device is capable of comparing the amount to a reference amount indicative of the amount of the compound in fluid or tissue of an individual that has, or will have, the systemic inflammatory condition. 
       
     
     
         20 . A system for the diagnosis or prognosis of a systemic inflammatory condition comprising a first device capable of measuring the amount of a compound according to formula (I) 
       
         
           
           
               
               
           
         
         or a salt or solvate thereof, wherein R is C 16 -C 18  acyl, in fluid or tissue of the patient and a second device capable of comparing the amount to a reference amount indicative of the amount of the compound in fluid or tissue of an individual that has, or will have, the systemic inflammatory condition to assess risk for the systemic inflammatory condition.