Impact of Plasma 5 Hydroxyindoleacetic Acid, a Serotonin Metabolite, on Clinical Severity in Acute Respiratory Distress Syndrome

Takeshi Tanaka; Masahiko Mori; Masato Tashiro; Koichi Izumikawa

doi:10.3389/fmed.2021.785409

Impact of Plasma 5 Hydroxyindoleacetic Acid, a Serotonin Metabolite, on Clinical Severity in Acute Respiratory Distress Syndrome

Front Med (Lausanne). 2021 Dec 16:8:785409. doi: 10.3389/fmed.2021.785409. eCollection 2021.

Authors

Takeshi Tanaka¹, Masahiko Mori², Masato Tashiro^{1

3}, Koichi Izumikawa^{1

3}

Affiliations

¹ Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan.
² Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
³ Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Abstract

Acute respiratory distress syndrome (ARDS) is characterized by dysregulated vascular permeability. The clinical outcomes remain poor, and the disease burden is widespread. We demonstrated that plasma 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite, is a pivotal severity indicator of ARDS. Serotonin is an effector of cellular contraction and a modulator of vascular permeability. Plasma 5-HIAA levels were significantly elevated in severe ARDS cases with shock status (p = 0.047) and positively correlated with SOFA (p < 0.0001) and APACHE-II score (p < 0.0001). In the longitudinal analysis, plasma 5-HIAA levels were also a strong independent predictor of mortality rate (p = 0.005). This study indicates that plasma 5-HIAA is a biomarker of ARDS severity and highlights the importance of evaluating vascular leakage levels for ARDS treatment.

Keywords: 5-HIAA (5-hydroxyindoleacetic acid); ARDS; serotonin; shock; vascular permeability.