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The following is a summary of “High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration,” published in the August 2024 issue of Critical Care by Rusev et al.

Glucocorticoid-induced leucine zipper (GILZ) plays a crucial role in sepsis by regulating the delicate balance between inflammation and anti-inflammation.

Researchers conducted a retrospective study examining GILZ transcript variants in patients with sepsis to assess further the potential for randomization, enhancing glucocorticoid therapy.

They recruited patients with sepsis, and RNA was isolated from the blood sample. Quantitative mRNA expression of GILZ variants in both patients with sepsis  (n=121) and the monocytic U937 cell line (n=3) was assessed using quantitative PCR (qPCR) and treated with hydrocortisone and lipopolysaccharides. 

The results showed increased expression of GILZTV 1, a marker for heightened 30-day mortality in patients with sepsis. Augmented levels of GILZ TV 1 within the initial day of sepsis onset were associated with a 2.2-[95% CI 1.2–4.3] fold rise in mortality, escalating to an 8.5-[95% CI 2.0–36.4] fold increase by day 8. Glucocorticoids enhanced the expression of GILZ TV 1, which increased throughout sepsis and in response to hydrocortisone treatment. Furthermore, a high ratio of transcript variant 1 relative to all GILZ mRNA TVs was linked with a 2.3-fold higher mortality rate in patients receiving hydrocortisone treatment.

They concluded that high expression of GILZ TV 1 was associated with increased 30-day sepsis mortality and could identify patient subgroups where hydrocortisone might be harmful.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05056-1