Egypt J Pediatr Allergy Immunol, (October 2015), Volume No. 13, Issue 02  
Egypt J Pediatr Allergy Immunol 2015 ; 13 ( 02 ) : 65 - 71
, ESP - 200  
Original articles
Evaluation of Osteopontin role in Children with systemic inflammatory response syndrome (SIRS) and Sepsis
DR.Mohamed Ahmed Talat Kamal,   DR. Hanaa Hosny          
Introduction: Sepsis is a leading cause of morbidity and mortality in critically ill children despite the use of modern antibiotics and resuscitation therapies. Sepsis must be distinguished from non-infection systemic inflammatory response syndrome (SIRS) induced by agents such as trauma and ischemia causing extensive tissue injury to establish appropriate treatments in critically ill patients. Osteopontin acts as an extracellular matrix component or soluble cytokine in inflamed tissues. Its exact role in immune response and sepsis remains to be elucidated. Objective: This study was undertaken to investigate the level of osteopontin in SIRS and sepsis to assess its involvement in the pathogenesis of these acute inflammatory diseases, its possible role as a marker of the disease status (by differentiating the children with SIRS from those with sepsis). Subjects and Methods: Prospective, observational study at pediatric ICU at the childrenís Hospital, Zagazig University, Egypt, from October 2013 to December 2014. Forty-four patients with SIRS or sepsis and 44 healthy subjects were enrolled. All the children were subjected to detailed medical history, Clinical examination, laboratory estimation for CBC, blood cultures, serum osteopontin and IL-6 determination was performed by sandwich enzyme immunoassay technique. Statistical methods The Mann-Whitney test and Spearmanís correlation coefficients were used for statistical analysis Results: Serum osteopontin levels were significantly higher in patients than in controls and in sepsis than in SIRS, and decreased during the resolution of both the disorders. Receiver operating characteristic curves showed that osteopontin levels have discriminative power between SIRS and sepsis with an area under the curve of 0.833. Osteopontin levels directly correlated interleukin-6 levels and clinical severity scores. Conclusion: Osteopontin is strongly up-regulated during SIRS and sepsis and correlate with IL6 and clinical severity scores.