Increased expression of neutrophil-related genes in patients with early sepsis-induced ARDS

Kirsten Neudoerffer Kangelaris, Arun Prakash, Kathleen D. Liu, Bradley Aouizerat, Prescott G. Woodruff, David J. Erle, Angela Rogers, Eric J. Seeley, Jeffrey Chu, Tom Liu, Thomas Osterberg-Deiss, Hanjing Zhuo, Michael A. Matthay, Carolyn S. Calfee

Research output: Contribution to journalArticlepeer-review


The early sequence of events leading to the development of the acute respiratory distress syndrome (ARDS) in patients with sepsis remains inadequately understood. The purpose of this study was to identify changes in gene expression early in the course of illness, when mechanisms of injury may provide the most relevant treatment and prognostic targets. We collected whole blood RNA in critically ill patients admitted from the Emergency Department to the intensive care unit within 24 h of admission at a tertiary care center. Whole genome expression was compared in patients with sepsis and ARDS to patients with sepsis alone. We selected genes with >1 log2 fold change and false discovery rate <0.25, determined their significance in the literature, and performed pathway analysis. Several genes were upregulated in 29 patients with sepsis with ARDS compared with 28 patients with sepsis alone. The most differentially expressed genes included key mediators of the initial neutrophil response to infection: olfactomedin 4, lipocalin 2, CD24, and bactericidal/permeability-increasing protein. These gene expression differences withstood adjustment for age, sex, study batch, white blood cell count, and presence of pneumonia or aspiration. Pathway analysis demonstrated overrepresentation of genes involved in known respiratory and infection pathways. These data indicate that several neutrophil-related pathways may be involved in the early pathogenesis of sepsis-related ARDS. In addition, identifiable gene expression differences occurring early in the course of sepsis-related ARDS may further elucidate understanding of the neutrophil-related mechanisms in progression to ARDS.

Original languageEnglish (US)
Pages (from-to)L1102-L1113
JournalAmerican Journal of Physiology - Lung Cellular and Molecular Physiology
Issue number11
StatePublished - Jun 1 2015


  • ARDS
  • Gene expression
  • Neutrophils
  • Sepsis

ASJC Scopus subject areas

  • Physiology
  • Pulmonary and Respiratory Medicine
  • Physiology (medical)
  • Cell Biology


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