PURPOSE: Pentraxin 3 (PTX3) is an inflammatory mediator produced by neutrophils, 
macrophages, myeloid dendritic and endothelial cells. During sepsis a massive 
inflammatory activation and coagulation/fibrinolysis dysfunction occur. PTX3, as 
a mediator of inflammation, may represent an early marker of severity and 
outcome in sepsis.
METHODS: This study is based on a prospective trial regarding the impact of 
glycemic control on coagulation in sepsis. Ninety patients admitted to three 
general intensive care units were enrolled when severe sepsis or septic shock 
was diagnosed. At enrollment, we recorded sepsis signs, disease severity, 
coagulation activation [prothrombin fragments 1 + 2 (F(1+2))] and fibrinolysis 
inhibition [plasminogen activator inhibitor-1 (PAI-1)]. We measured plasma PTX3 
levels at enrollment, everyday until day 7, then at days 9, 11, 13, 18, 23 and 
28. Mortality was recorded at day 90.
RESULTS: Although not different on day 1, PTX3 remained significantly higher in 
non-survivors than in survivors over the first 5 days (p = 0.002 by general 
linear model). On day 1, PTX3 levels were higher in septic shock than in 
severely septic patients (p = 0.029). Day 1 PTX3 was significantly correlated 
with platelet count (p < 0.001), SAPS II score (p = 0.006) and SOFA score (p < 
0.001). Day 1 PTX3 was correlated with F(1+2) concentration and with PAI-1 
activity and concentration (p < 0.05 for all).
CONCLUSIONS: Persisting high levels of circulating PTX3 over the first days from 
sepsis onset may be associated with mortality. PTX3 correlates with severity of 
sepsis and with sepsis-associated coagulation/fibrinolysis dysfunction.