1
|
Rehan ST, Imran L, Eqbal F, Khan Z, Nashwan AJ, Asghar MS. Prognostic role of suPAR in acute pancreatitis: A protocol for systematic review. Medicine (Baltimore) 2024; 103:e37064. [PMID: 38941433 DOI: 10.1097/md.0000000000037064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Acute pancreatitis (AP) is a common emergency condition with high morbidity, mortality, and socio-economic impact. Soluble urokinase plasminogen activator receptor (suPAR) is a potential biomarker for AP prognosis. This study systematically reviews the literature on suPAR's prognostic roles in assessing AP severity, organ failure, mortality, and other pathological markers. METHODS A comprehensive search of 5 databases up to March 19, 2023, was conducted, selecting cohort studies that examined suPAR's relationship with AP outcomes. Outcome variables included AP severity, organ failure, mortality, hospital stay length, and suPAR's association with other inflammatory markers. Our paper has been registered on Prospero (ID: CRD42023410628). RESULTS Nine prospective observational studies with 1033 AP patients were included. Seven of eight studies found suPAR significantly elevated in severe acute pancreatitis (P < .05). Four studies showed suPAR effectively predicted organ failure risk, and 4 studies concluded suPAR significantly predicted mortality (P < .05). The review had no high-risk studies, enhancing credibility. CONCLUSION suPAR is a valuable prognostic marker in AP, significantly predicting severity, organ failure, hospital stay length, and mortality. Further large-scale studies are needed to explore suPAR's role in other clinical outcomes related to AP disease course, to establish it as a mainstay of AP prognosis.
Collapse
Affiliation(s)
| | - Laiba Imran
- Department of Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Farea Eqbal
- Department of Medicine, Dow University of Health Science, Karachi, Pakistan
| | - Zayeema Khan
- Department of Medicine, Dow University of Health Science, Karachi, Pakistan
| | | | | |
Collapse
|
2
|
Erbak Yılmaz H, Aksun S, Günay S, Elmalı F, Çekiç C. Evaluation of plasma soluble urokinase plasminogen activator receptor (SuPAR) levels in ulcerative colitis. Arab J Gastroenterol 2023; 24:175-179. [PMID: 37045728 DOI: 10.1016/j.ajg.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 02/13/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND STUDY AIM Soluble urokinase plasminogen activator receptor (SuPAR), a soluble form of the urokinase-type plasminogen activator receptor, is a biomarker produced by macrophages, monocytes, neutrophils, active T cells, endothelial cells, and circulating tumor cells. SuPAR is a novel biomarker showing altered inflammation in many inflammatory diseases. This study aims to investigate the SuPAR level in ulcerative colitis (UC) patients, and to evaluate the SuPAR level in active, and remission patients. PATIENTS AND METHODS Patient and healthy control SuPAR levels were analyzed by immunoassay method. SuPAR levels between UC patients and control group were compared. The difference between SuPAR levels in patients with active UC and UC in remission was analyzed. The relationship between C-reactive protein level, Total Mayo score, Mayo Endoscopic score used to predict disease activity, and amount of SuPAR were evaluated. RESULTS SuPAR levels were determined in the UC patient group (2170,3 ± 121,0 pg/ml), and healthy controls (2130,7 ± 164,8 pg/ml) (p = 0. 805). Median SuPAR levels were determined in moderate UC (2479 pg/ml), mild UC (1944 pg/ml), and patients in remission (1774 pg/ml) (p = 0,207). There were no significant relationships between SuPAR levels and CRP levels, Total Mayo score, disease duration in the UC group (r = 0.177, r = 0.267, and r = 0,007; respectively p > 0.05). A slightly positive correlation was found between Mayo Endoscopic Score and SuPAR level (r = 0.303; p = 0.031). CONCLUSION SuPAR is of limited value in the diagnosis of ulcerative colitis and in the assessment of disease activation.
Collapse
Affiliation(s)
- Huriye Erbak Yılmaz
- Izmir Katip Çelebi University Atatürk Training and Research Hospital, Biochemistry Laboratory Izmir, Turkey; Izmir Biomedicine and Genom Center, Izmir, Turkey.
| | - Saliha Aksun
- Izmir Katip Çelebi University, Department of Biochemistry, Izmir, Turkey
| | - Süleyman Günay
- Izmir Katip Çelebi University, Department of Gastroenterology, Izmir, Turkey
| | - Ferhan Elmalı
- Izmir Katip Çelebi University, Department of Biostatistics, Izmir, Turkey
| | - Cem Çekiç
- Izmir Tinaztepe University, Department of Gastroenterology, Izmir, Turkey
| |
Collapse
|
3
|
Wang Y, Xu Z, Zhou Y, Xie M, Qi X, Xu Z, Cai Q, Sheng H, Chen E, Zhao B, Mao E. Leukocyte cell population data from the blood cell analyzer as a predictive marker for severity of acute pancreatitis. J Clin Lab Anal 2021; 35:e23863. [PMID: 34062621 PMCID: PMC8274994 DOI: 10.1002/jcla.23863] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prediction for severe acute pancreatitis (SAP) is the key to give timely targeted treatment. Leukocyte cell population data (CPD) have been widely applied in early prediction and diagnosis of many diseases, but their predictive ability for SAP remains unexplored. We aim to testify whether CPD could be an indicator of AP severity in the early stage of the disease. METHODS The prospective observational study was conducted in the emergency department ward of a territory hospital in Shanghai. The enrolled AP patients should meet 2012 Atlanta guideline. RESULTS Totally, 103 AP patients and 62 healthy controls were enrolled and patients were classified into mild AP (n = 30), moderate SAP (n = 42), and SAP (n = 31). Forty-two CPD parameters were examined in first 3 days of admission. Four CPD parameters were highest in SAP on admission and were constantly different among 3 groups during first 3 days of hospital stay. Eighteen CPD parameters were found correlated with the occurrence of SAP. Stepwise multivariate logistic regression analysis identified a scoring system of 4 parameters (SD_LALS_NE, MN_LALS_LY, SD_LMALS_MO, and SD_AL2_MO) with a sensitivity of 96.8%, specificity of 65.3%, and AUC of 0.87 for diagnostic accuracy on early identification of SAP. AUC of this scoring system was comparable with MCTSI, SOFA, APACHE II, MMS, BISAP, or biomarkers as CRP, PCT, and WBC in prediction of SAP and ICU transfer or death. CONCLUSIONS Several leukocyte CPD parameters have been identified different among MAP, MSAP, and SAP. They might be ultimately incorporated into a predictive system marker for severity of AP.
Collapse
Affiliation(s)
- Yihui Wang
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhihong Xu
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yuhua Zhou
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Mengqi Xie
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Xing Qi
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhiwei Xu
- Department of General SurgeryPancreatic Disease CenterRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Qi Cai
- Department of Laboratory MedicineRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Huiqiu Sheng
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Erzhen Chen
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Bing Zhao
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Enqiang Mao
- Department of EmergencyRuijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| |
Collapse
|
4
|
Does Soluble Urokinase-Type Plasminogen Activator Receptor Level Predicts the Occurrence of Inflammatory Complications in Maxillofacial Surgery? APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Soluble urokinase-type plasminogen activator receptor (suPAR) is a marker of immune activation and reflects a more distinct aspect of inflammation than C-reactive protein (CRP) does. The study concerns a clinically silent state of the immune system expressed by the level of suPAR, which could affect the occurrence of complications (non-life threatening) after scheduled procedures. The purpose was the evaluation of suPAR predictive value in minor maxillofacial surgery complication incidents. Eighty patients were tested for suPAR, CRP and a series of basic laboratory serum tests on 1 day before surgery. Complications of orthognathic and minor injuries treatments were reported. The suPAR level, expressed as a measure independent of the patient’s age (Index of Body Inflammation, IBI), was analyzed. The protein level was also assessed on postoperative day 3. Basic statistical analysis did not reveal any relevant dependence between suPAR (or IBI) and occurrence of minor complications. The application of factor analysis, artificial neural network and inclusion of chlorides, glycaemia, alanine transaminase (ALT), albumin and hemoglobin levels allowed to indicate the suPAR/IBI ranges associated with an increased risk of minor postoperative complications. Concluding, it seems that, in the current state of the knowledge, the monitoring of pre-operational suPAR level solely does not include sufficient predictive information for the occurrence of minor complications after maxillofacial surgery. The suPAR/IBI level should be combined with other patient characteristics to predict healing complications.
Collapse
|
5
|
Bálint ER, Fűr G, Kiss L, Németh DI, Soós A, Hegyi P, Szakács Z, Tinusz B, Varjú P, Vincze Á, Erőss B, Czimmer J, Szepes Z, Varga G, Rakonczay Z. Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis. Sci Rep 2020; 10:17936. [PMID: 33087766 PMCID: PMC7578029 DOI: 10.1038/s41598-020-74943-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
The main causes of acute pancreatitis (AP) are biliary disease, alcohol consumption, hypertriglyceridaemia (HTG) and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this meta-analysis was to evaluate the effects of these aetiological factors on the severity and outcome of AP. Pubmed and Embase were searched between 01/01/2012 and 31/05/2020. Included articles involved adult alcoholic, biliary, HTG- or post-ERCP AP (PAP) patients. Primary outcome was severity, secondary outcomes were organ failures, intensive care unit admission, recurrence rate, pancreatic necrosis, mortality, length of hospital stay, pseudocyst, fluid collection and systematic inflammatory response syndrome. Data were analysed from 127 eligible studies. The risk for non-mild (moderately severe and severe) condition was the highest in HTG-induced AP (HTG-AP) followed by alcoholic AP (AAP), biliary AP (BAP) and PAP. Recurrence rate was significantly lower among BAP vs. HTG-AP or AAP patients (OR = 2.69 and 2.98, 95% CI 1.55–4.65 and 2.22–4.01, respectively). Mortality rate was significantly greater in HTG-AP vs. AAP or BAP (OR = 1.72 and 1.50, 95% CI 1.04–2.84 and 0.96–2.35, respectively), pancreatic necrosis occurred more frequently in AAP than BAP patients (OR = 1.58, 95% CI 1.08–2.30). Overall, there is a potential association between aetiology and the development and course of AP. HTG-AP is associated with the highest number of complications. Furthermore, AAP is likely to be more severe than BAP or PAP. Greater emphasis should be placed on determining aetiology on admission.
Collapse
Affiliation(s)
- Emese Réka Bálint
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Gabriella Fűr
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Lóránd Kiss
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Dávid István Németh
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Clinical Medicine Doctoral School, University of Szeged, Szeged, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,MTA-SZTE Momentum Translational Gastroenterology Research Group, Szeged, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Benedek Tinusz
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Péter Varjú
- First Department of Medicine, University of Pécs, Pécs, Hungary
| | - Áron Vincze
- First Department of Medicine, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - József Czimmer
- Institute for Translational Medicine and Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Zoltán Szepes
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Gábor Varga
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Zoltán Rakonczay
- Department of Pathophysiology, University of Szeged, Szeged, Hungary.
| |
Collapse
|
6
|
Acute pancreatitis and the weekend effect: does weekend admission affect patient outcome? GASTROENTEROLOGY REVIEW 2020; 15:241-246. [PMID: 33005270 PMCID: PMC7509903 DOI: 10.5114/pg.2020.95039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/01/2019] [Indexed: 11/20/2022]
Abstract
Introduction When a patient is admitted to a hospital for acute pancreatitis (AP), the day of the week on which the admission occurs may influence the outcome of care. The link between reduced weekend staffing practices and outcomes for patients hospitalised for AP, however, has been inadequately studied. Aim To evaluate the relationship between weekend admission and AP outcome. Material and methods One hundred and twenty-six patients were prospectively included, assessed according to the revised Atlanta criteria, and observed until discharge or death. Weekend and weekday admissions were compared in terms of severity, aetiology, length of hospital stay, and in-hospital mortality. Results Patients were divided into two groups according to the timing of admission (weekday, n = 99, 78.6%; or weekend, n = 27, 21.4%). AP was considered severe in 33 (26.2%) patients, moderately severe AP in 37 (29.4%) patients, and mild in 56 (44.4%) patients. No significant differences were found with regard to the distribution of AP severity between the two groups. The impact of weekend admission was not significant for aetiology or for the length of hospital stay (median of 9 vs. 10 days). In-hospital mortality rates were not significantly different for weekday and weekend admissions. Conclusions Patients admitted for hospitalisation during a weekend received the same level and quality of care at the facility under study as AP patients admitted during the week. Additionally, the rate of favourable outcomes for patients admitted during the weekend was found to be similar to the outcomes of patients admitted on a weekday.
Collapse
|
7
|
Rostropowicz-Honka A, Klinger M. Type 2 diabetes and chronic kidney disease as important prognostic factors in acute pancreatitis. POSTEP HIG MED DOSW 2019. [DOI: 10.5604/01.3001.0013.6093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study includes an analysis of acute pancreatitis (AP) prognostic factors was performed as well as a critical review of the most important AP prognostic scales (APACHE II, Ranson, BISAP, SOFA, Marshall). The limitations of each scale were described. Simultaneously, the clinical applicability in the early prognostic AP stratification was presented, along with the clinical value of the alcoholic and gallstones etiology in the differential diagnosis. Pre-existing type 2 diabetes and chronic kidney disease significantly worsen the course of AP and should be included in the prognostic scale. It was shown that the diabetes coexisting with a HBA1C level above 6.5% significantly increases the mortality of AP patients and prolongs the period of hospitalization for 5 days. It was also observed that chronic kidney disease significantly increases the frequency of infective AP complications and raises 3-months mortality.
Collapse
Affiliation(s)
- Anna Rostropowicz-Honka
- Klinika Chorób Wewnętrznych, Instytut Medycyny Uniwersytetu Opolskiego i Uniwersytecki Szpital Kliniczny, Opole
| | | |
Collapse
|
8
|
Rasmussen LJH, Ladelund S, Haupt TH, Ellekilde GE, Eugen-Olsen J, Andersen O. Combining National Early Warning Score With Soluble Urokinase Plasminogen Activator Receptor (suPAR) Improves Risk Prediction in Acute Medical Patients: A Registry-Based Cohort Study. Crit Care Med 2019; 46:1961-1968. [PMID: 30247244 PMCID: PMC6250248 DOI: 10.1097/ccm.0000000000003441] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Objectives: Soluble urokinase plasminogen activator receptor is a prognostic biomarker associated with critical illness, disease progression, and risk of mortality. We aimed to evaluate whether soluble urokinase plasminogen activator receptor adds prognostic value to a vital sign-based score for clinical monitoring of patient risk (National Early Warning Score) in acute medical patients. Design: Registry-based observational cohort study of consecutively admitted acute medical patients. Setting: The Acute Medical Unit, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark. Patients: Acute medical patients admitted between November 18, 2013, and September 30, 2015. Interventions: None. Measurements and Main Results: Of 17,312 included patients, admission National Early Warning Score was available for 16,244 (93.8%). During follow-up, 587 patients (3.4%) died in-hospital, 859 (5.0%) within 30 days, and 1,367 (7.9%) within 90 days. High soluble urokinase plasminogen activator receptor was significantly associated with in-hospital-, 30-day-, and 90-day mortality within all National Early Warning Score groups, in particular in patients with a low National Early Warning Score; for 30-day mortality, mortality rate ratios ranged from 3.45 (95% CI, 2.91–4.10) for patients with National Early Warning Score 0–1, to 1.86 (95% CI, 1.47–2.34) for patients with National Early Warning Score greater than or equal to 9 for every doubling in soluble urokinase plasminogen activator receptor (log2-transformed). Combining National Early Warning Score, age, and sex with soluble urokinase plasminogen activator receptor improved prediction of in-hospital-, 30-day-, and 90-day mortality, increasing the area under the curve (95% CI) for 30-day mortality from 0.86 (0.85–0.87) to 0.90 (0.89–0.91), p value of less than 0.0001, with a negative predictive value of 99.0%. Conclusions: The addition of soluble urokinase plasminogen activator receptor to National Early Warning Score significantly improved risk prediction of both low- and high-risk acute medical patients. Patients with low National Early Warning Score but elevated soluble urokinase plasminogen activator receptor had mortality risks comparable to that of patients with higher National Early Warning Score.
Collapse
Affiliation(s)
- Line J H Rasmussen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Steen Ladelund
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Thomas H Haupt
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Gertrude E Ellekilde
- The Acute Medical Unit, The Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.,Quality and Patient Safety, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Jesper Eugen-Olsen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Ove Andersen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| |
Collapse
|
9
|
Serum Urokinase-Type Plasminogen Activator Receptor Does Not Outperform C-Reactive Protein and Procalcitonin as an Early Marker of Severity of Acute Pancreatitis. J Clin Med 2018; 7:jcm7100305. [PMID: 30262764 PMCID: PMC6210514 DOI: 10.3390/jcm7100305] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/15/2018] [Accepted: 09/19/2018] [Indexed: 12/27/2022] Open
Abstract
Severe acute pancreatitis (SAP) concerns 10–20% of acute pancreatitis (AP) patients and is associated with a poor prognosis and high mortality. An early prognosis of the unfavorable outcome, transfer to an intensive care unit (ICU) and the introduction of an adequate treatment are crucial for patients’ survival. Recently, the elevated circulating urokinase-type plasminogen activator receptor (uPAR) has been reported to predict SAP with a high diagnostic accuracy among patients in a tertiary center. The aim of the study was to compare the diagnostic utility of uPAR and other inflammatory markers as the predictors of the unfavorable course of AP in patients admitted to a secondary care hospital within the first 24 h of the onset of AP. The study included 95 patients, eight with a SAP diagnosis. Serum uPAR was measured on admission and in the two subsequent days. On admission, uPAR significantly predicted organ failure, acute cardiovascular failure, acute kidney injury, the need for intensive care, and death. The diagnostic accuracy of the admission uPAR for the prediction of SAP, organ failure, and ICU transfer or death was low to moderate and did not differ significantly from the diagnostic accuracy of interleukin-6, C-reactive protein, procalcitonin, D-dimer and soluble fms-like tyrosine kinase-1. In the secondary care hospital, where most patients with AP are initially admitted, uPAR measurements did not prove better than the currently used markers.
Collapse
|
10
|
Hamie L, Daoud G, Nemer G, Nammour T, El Chediak A, Uthman IW, Kibbi AG, Eid A, Kurban M. SuPAR, an emerging biomarker in kidney and inflammatory diseases. Postgrad Med J 2018; 94:517-524. [PMID: 30177549 DOI: 10.1136/postgradmedj-2018-135839] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/10/2018] [Accepted: 07/28/2018] [Indexed: 12/12/2022]
Abstract
Soluble urokinase plasminogen activator receptor (suPAR) is a circulating form of a physiological and pathophysiological important cell surface receptor, implicated in inflammation. Recent studies showed that suPAR is a promising biomarker, useful for diagnosis, assessment and prognosis of several diseases. This review summarises the majority of preliminary studies and analyses the significance and the clinical application of suPAR in various clinical conditions. SuPAR seems to have a significant value in the diagnosis as well as prognosis of many diseases; nonetheless, it merits large-scale studies to set cut-off values that help physicians in following up their patients and accordingly tailor their treatment plans.
Collapse
Affiliation(s)
- Lamiaa Hamie
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Georges Daoud
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Georges Nemer
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Tarek Nammour
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alissar El Chediak
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad W Uthman
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abdul Ghani Kibbi
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Assaad Eid
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mazen Kurban
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon .,Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
11
|
Immature granulocytes predict severe acute pancreatitis independently of systemic inflammatory response syndrome. GASTROENTEROLOGY REVIEW 2017; 12:140-144. [PMID: 28702104 PMCID: PMC5497134 DOI: 10.5114/pg.2017.68116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/28/2017] [Indexed: 12/29/2022]
Abstract
Introduction Early prediction of severity of acute pancreatitis (AP) by a simple parameter that positively correlates with the activation stage of the immune system would be very helpful because it could influence the management and improve the outcome. Tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1) play a critical role in the pathogenesis systemic inflammatory response syndrome (SIRS) and severity of AP. One of the effects of IL-1 and TNF-α is an increase in the number of immature granulocytes (IGs) in the peripheral blood. Aim To assess whether the IGs% in plasma could be an independent marker of AP severity. Material and methods A cohort of 77 patients with AP were prospectively enrolled in the study. The IGs were measured from whole blood samples obtained from the first day of hospitalization using an automated analyser. Results We observed 44 (57%) patients with mild AP, 21 (27%) patients with moderate severe AP (SAP) and 12 (16%) patients with SAP. The cut-off value of IGs was 0.6%. The IGs > 0.6% had a sensitivity, specificity, and positive and negative predictive value of 100%, 96%, 85.7%, and 100%, respectively (area under the curve (AUC) = 0.98). On admission, SIRS was present in 25 (32%) patients. We found that in patients who fulfilled at least two criteria for SIRS, SAP could be predicted with 75% sensitivity and 75.4% specificity, positive predictive value 36%, negative predictive value 94.2%. Conclusions The IGs% as a routinely obtained marker appears to be a promising, independent biomarker and a better predictor of early prognosis in SAP than SIRS and white blood cell.
Collapse
|
12
|
Xiao H, Huang JH, Zhang XW, Ahmed R, Xie QL, Li B, Zhu YM, Cai X, Peng QH, Qin YH, Huang HY, Wang W. Identification of potential diagnostic biomarkers of acute pancreatitis by serum metabolomic profiles. Pancreatology 2017; 17:543-549. [PMID: 28487129 DOI: 10.1016/j.pan.2017.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/13/2017] [Accepted: 04/18/2017] [Indexed: 12/11/2022]
Abstract
Acute pancreatitis (AP) is defined as an acute inflammation of pancreas that may cause damage to other tissues and organs depending upon the severity of symptoms. The diagnosis of AP is usually made by detection of raised circulating pancreatic enzyme levels, but there are occasional false positive and false negative diagnoses and such tests are often normal in delayed presentations. More accurate biomarkers would help in such situations. In this study, the global metabolites' changes of AP patients (APP) were profiled by using gas chromatography-mass spectrometry (GC-MS). Multivariate pattern recognition techniques were used to establish the classification models to distinguish APP from healthy participants (HP). Some significant metabolites including 3-hydroxybutyric acid, phosphoric acid, glycerol, citric acid, d-galactose, d-mannose, d-glucose, hexadecanoic acid and serotonin were selected as potential biomarkers for helping clinical diagnosis of AP. Furthermore, the metabolite changes in APP with severe and mild symptoms were also analyzed. Based on the selected biomarkers, some relevant pathways were also identified. Our results suggested that GC-MS based serum metabolomics method can be used in the clinical diagnosis of AP by profiling potential biomarkers.
Collapse
Affiliation(s)
- Hong Xiao
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Jian-Hua Huang
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China; Hunan Provincial Key Laboratory of Diagnostics in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Xing-Wen Zhang
- The People's Hospital of Hunan Province, Emergency Department, Changsha, 410208, PR China.
| | - Rida Ahmed
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China; Department of Basic Sciences, DHA Suffa University, 75500, Karachi, Pakistan
| | - Qing-Ling Xie
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Bin Li
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Yi-Ming Zhu
- The People's Hospital of Hunan Province, Emergency Department, Changsha, 410208, PR China
| | - Xiong Cai
- Hunan Provincial Key Laboratory of Diagnostics in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Qing-Hua Peng
- Hunan Provincial Key Laboratory of Diagnostics in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Yu-Hui Qin
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Hui-Yong Huang
- Hunan Provincial Key Laboratory of Diagnostics in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, PR China
| | - Wei Wang
- TCM and Ethnomedicine Innovation & Development Laboratory, Sino-Pakistan TCM Research Center, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, PR China; Hunan Provincial Key Laboratory of Diagnostics in Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, PR China.
| |
Collapse
|