Intensive Care Medicine

, Volume 36, Issue 1, pp 123–130 | Cite as

Changes in peroxisome proliferator-activated receptor-gamma activity in children with septic shock

  • Jennifer M. KaplanEmail author
  • Alvin Denenberg
  • Marie Monaco
  • Marchele Nowell
  • Hector Wong
  • Basilia Zingarelli
Pediatric Original



To assess changes in peroxisome proliferator-activated receptor-γ (PPARγ) in peripheral blood mononuclear cells (PBMC) from critically ill children with sepsis. Additionally, to investigate the effects of sepsis on the endogenous activator of PPARγ, 15-deoxy-∆12,14-PGJ2 (15d-PGJ2), and the downstream targets of PPARγ activity, adiponectin and resistin.


Single-center, prospective case–control study in critically ill children with systemic inflammatory response syndrome, sepsis or septic shock.


PPARγ nuclear protein expression was decreased but PPARγ activity was increased in PBMC from children with septic shock compared with controls. PPARγ activity on day 1 was significantly higher in patients with higher pediatric risk of mortality (PRISM) score compared with controls [mean 0.22 optical density (OD) ± standard error of the mean (SEM) 0.03 versus 0.12 OD ± 0.02; p < 0.001]. Patients with resolved sepsis had increased levels of the endogenous PPARγ ligand, 15d-PGJ2, compared with patients with systemic inflammatory response syndrome (SIRS) and septic shock (77.7 ± 21.7 versus 58 ± 16.5 pg/ml; p = 0.03). Plasma high-molecular-weight adiponectin (HMWA) and resistin levels were increased in patients with septic shock on day 1 and were significantly higher in patients with higher PRISM scores. Nonsurvivors from sepsis had higher resistin levels on the first day of hospitalization compared with survivors from septic shock [660 ng/ml, interquartile range (IQR) 585–833 ng/ml versus 143 ng/ml, IQR 66–342 ng/ml; p < 0.05].


Sepsis is associated with altered PPARγ expression and activity in PBMC. Plasma adipokines correlate with risk of mortality scores in sepsis and may be useful biomarkers. Further studies are needed to understand the mechanisms underlying changes in PPARγ in sepsis.


Sepsis Resistin Adiponectin 15-Deoxy-∆12,14-PGJ2 PPARγ Cytokines 



We would like to thank the parents who enrolled their children into this study during an emotionally difficult time. Supported, in part, by grants K12 HD028827 (J.M.K.), T32 ES10957 (J.M.K.), R01 GM067202 (B.Z.), and R01 GM064619 (H.W.) from the NIH, Bethesda, MD, and by the Translational Research Initiative at Cincinnati Children’s Hospital Medical Center (J.M.K.).

Supplementary material

134_2009_1654_MOESM1_ESM.doc (32 kb)
Supplementary material 1 (DOC 32 kb)


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Copyright information

© Copyright jointly hold by Springer and ESICM 2009

Authors and Affiliations

  • Jennifer M. Kaplan
    • 1
    Email author
  • Alvin Denenberg
    • 1
  • Marie Monaco
    • 1
  • Marchele Nowell
    • 1
  • Hector Wong
    • 1
  • Basilia Zingarelli
    • 1
  1. 1.Cincinnati Children’s Hospital Medical CenterThe University of Cincinnati College of MedicineCincinnatiUSA

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