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Klim SM, Prattes J, Amerstorfer F, Niedrist T, Zurl C, Stradner M, Dreo B, Glehr G, Leithner A, Glehr M, Reinbacher P, Sadoghi P, Hauer G. Soluble Urokinase Plasminogen Activator Receptor (SuPAR) Analysis for Diagnosis of Periprosthetic Joint Infection. Antibiotics (Basel) 2024; 13:179. [PMID: 38391565 PMCID: PMC10885937 DOI: 10.3390/antibiotics13020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
Soluble urokinase plasminogen activator receptors (suPARs) are a biomarker for inflammatory diseases. This study aims to investigate its diagnostic properties regarding periprosthetic joint infections (PJI). This retrospective cohort study included adult patients who underwent joint puncture for suspected PJI. The presence of PJI was determined according to the criteria of the European Bone and Joint Infection Society (EBJIS). Laboratory study analyses included the determination of white blood cells (WBC) in whole blood, C-reactive protein (CRP) in blood plasma, and suPAR in both blood plasma and synovial fluid. Appropriate diagnostic cut-off values were identified utilizing Youden's J, and their diagnostic performance was determined by calculating the positive (PPV) and negative predictive value (NPV) for each marker. Sixty-seven cases were included in the final analysis. Forty-three samples (64%) were identified as periprosthetic joint infection (PJI) and twenty-four specimen (36%) were PJI negative cases. The PPV and NPV were 0.80 and 0.70 for synovial suPAR, 0.86 and 0.55 for CRP, 0.84 and 0.31 for WBC and 1.00 and 0.31 for plasma suPAR. Synovial suPAR showed a solid diagnostic performance in this study and has the potential to be an alternative or complementary biomarker for PJI. Further investigations in larger patient collectives are indicated.
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Affiliation(s)
- Sebastian M Klim
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Jürgen Prattes
- Department of Internal Medicine, Division of Infectious Diseases, Medical University of Graz, 8036 Graz, Austria
| | - Florian Amerstorfer
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Christoph Zurl
- Department of Internal Medicine, Division of Infectious Diseases, Medical University of Graz, 8036 Graz, Austria
| | - Martin Stradner
- Department of Internal Medicine, Division of Rheumatology and Immunology, Medical University of Graz, 8036 Graz, Austria
| | - Barbara Dreo
- Department of Internal Medicine, Division of Rheumatology and Immunology, Medical University of Graz, 8036 Graz, Austria
| | - Gunther Glehr
- Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Mathias Glehr
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Patrick Reinbacher
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Patrick Sadoghi
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
| | - Georg Hauer
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
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Cao XS, Zheng WQ, Hu ZD. Diagnostic value of soluble biomarkers for parapneumonic pleural effusion. Crit Rev Clin Lab Sci 2023; 60:233-247. [PMID: 36593742 DOI: 10.1080/10408363.2022.2158779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Parapneumonic pleural effusion (PPE) is a common complication in patients with pneumonia. Timely and accurate diagnosis of PPE is of great value for its management. Measurement of biomarkers in circulating and pleural fluid have the advantages of easy accessibility, short turn-around time, objectiveness and low cost and thus have utility for PPE diagnosis and stratification. To date, many biomarkers have been reported to be of value for the management of PPE. Here, we review the values of pleural fluid and circulating biomarkers for the diagnosis and stratification PPE. The biomarkers discussed are C-reactive protein, procalcitonin, presepsin, soluble triggering receptor expressed on myeloid cells 1, lipopolysaccharide-binding protein, inflammatory markers, serum amyloid A, soluble urokinase plasminogen activator receptor, matrix metalloproteinases, pentraxin-3 and cell-free DNA. We found that none of the available biomarkers has adequate performance for diagnosing and stratifying PPE. Therefore, further work is needed to identify and validate novel biomarkers, and their combinations, for the management of PPE.
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Affiliation(s)
- Xi-Shan Cao
- Department of Laboratory Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Wen-Qi Zheng
- Department of Laboratory Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Zhi-De Hu
- Department of Laboratory Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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Idell S, Lee YCG. suPAR Surprises as a Biomarker of Invasive Outcomes in Pleural Infection. Am J Respir Crit Care Med 2020; 201:1470-1472. [PMID: 32176528 PMCID: PMC7301739 DOI: 10.1164/rccm.202003-0525ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Steven Idell
- Department of Cellular and Molecular BiologyUniversity of Texas Health Science Center at TylerTyler, Texasand
| | - Y. C. Gary Lee
- Sir Charles Gairdner Hospital and University of Western AustraliaPerth, Western Australia, Australia
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Arnold DT, Hamilton FW, Elvers KT, Frankland SW, Zahan-Evans N, Patole S, Medford A, Bhatnagar R, Maskell NA. Pleural Fluid suPAR Levels Predict the Need for Invasive Management in Parapneumonic Effusions. Am J Respir Crit Care Med 2020; 201:1545-1553. [PMID: 32069085 PMCID: PMC7301729 DOI: 10.1164/rccm.201911-2169oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Rationale: Parapneumonic effusions have a wide clinical spectrum. The majority settle with conservative management but some progress to complex collections requiring intervention. For decades, physicians have relied on pleural fluid pH to determine the need for chest tube drainage despite a lack of prospective validation and no ability to predict the requirement for fibrinolytics or thoracic surgery.Objectives: To study the ability of suPAR (soluble urokinase plasminogen activator receptor), a potential biomarker of pleural fluid loculation, to predict the need for invasive management compared with conventional fluid biomarkers (pH, glucose, and lactate dehydrogenase) in parapneumonic effusions.Methods: Patients presenting with pleural effusions were prospectively recruited to an observational study with biological samples stored at presentation. Pleural fluid and serum suPAR levels were measured using the suPARnostic double-monoclonal antibody sandwich ELISA on 93 patients with parapneumonic effusions and 47 control subjects (benign and malignant effusions).Measurements and Main Results: Pleural suPAR levels were significantly higher in effusions that were loculated versus nonloculated parapneumonic effusions (median, 132 ng/ml vs. 22 ng/ml; P < 0.001). Pleural suPAR could more accurately predict the subsequent insertion of a chest tube with an area under the curve (AUC) of 0.93 (95% confidence interval, 0.89-0.98) compared with pleural pH (AUC 0.82; 95% confidence interval, 0.73-0.90). suPAR was superior to the combination of conventional pleural biomarkers (pH, glucose, and lactate dehydrogenase) when predicting the referral for intrapleural fibrinolysis or thoracic surgery (AUC 0.92 vs. 0.76).Conclusions: Raised pleural suPAR was predictive of patients receiving more invasive management of parapneumonic effusions and added value to conventional biomarkers. These results need validation in a prospective multicenter trial.
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Affiliation(s)
- David T. Arnold
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | - Fergus W. Hamilton
- North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom; and
| | - Karen T. Elvers
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | | | | | - Sonia Patole
- North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom; and
| | - Andrew Medford
- North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom; and
| | - Rahul Bhatnagar
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
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Knaus J, Schaffarczyk D, Cölfen H. On the Future Design of Bio-Inspired Polyetheretherketone Dental Implants. Macromol Biosci 2019; 20:e1900239. [PMID: 31802617 DOI: 10.1002/mabi.201900239] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/10/2019] [Indexed: 11/09/2022]
Abstract
Polyetheretherketone (PEEK) is a promising implant material because of its excellent mechanical characteristics. Although this polymer is a standard material in spinal applications, PEEK is not in use in the manufacturing of dental implants, where titanium is still the most-used material. This may be caused by its relative bio-inertness. By the use of various surface modification techniques, efforts have been made to enhance its osseointegrative characteristics to enable the polymer to be used in dentistry. In this feature paper, the state-of-the-art for dental implants is given and different surface modification techniques of PEEK are discussed. The focus will lie on a covalently attached surface layer mimicking natural bone. The usage of such covalently anchored biomimetic composite materials combines many advantageous properties: A biocompatible organic matrix and a mineral component provide the cells with a surrounding close to natural bone. Bone-related cells may not recognize the implant as a foreign body and therefore, may heal and integrate faster and more firmly. Because neither metal-based nor ceramics are ideal material candidates for a dental implant, the combination of PEEK and a covalently anchored mineralized biopolymer layer may be the start of the desired evolution in dental surgery.
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Affiliation(s)
- Jennifer Knaus
- Department of Chemistry, Physical Chemistry, University of Konstanz, Universitätsstraße 10, 78457, Konstanz, Germany.,stimOS GmbH, Byk-Gulden-Straße 2, 78467, Konstanz, Germany
| | | | - Helmut Cölfen
- Department of Chemistry, Physical Chemistry, University of Konstanz, Universitätsstraße 10, 78457, Konstanz, Germany
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Saleh M, Taşar-Faruk S. Comparing the marginal leakage and retention of implant-supported restorations cemented by four different dental cements. Clin Implant Dent Relat Res 2019; 21:1181-1188. [PMID: 31692215 DOI: 10.1111/cid.12850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/12/2019] [Accepted: 09/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the wide use of implants in dentistry, there is insufficient information about the ideal cement for retention. PURPOSE To determine the cement bond strength and marginal leakage of crown and partial denture cemented to implant abutments by four different types of cement. MATERIALS AND METHODS Eighty-four direct abutments were divided into eight groups (n = 7). Fifty-six crown and bridge restorations were cemented using zinc phosphate (ZM), temporary cement (TM), resin-modified glass-ionomer cement (GM), and self-adhesive resin cement (RM). After cementation, thermal cycling and incubation in basic fuchsin dye was applied. The maximum load to failure, marginal leakage, and fracture modes were evaluated. RESULTS The mean of retention strength for the bridges (874 N) was higher than the crown samples (705 N) (P = .005). The mean of retention strength for each cement group was ZM = 1298, RM = 1027, GM = 646, and TM = 187 N (P ≤ .0001). Marginal leakage was recorded in majority of the samples; the highest incidence was detected for ZM samples. The cement fracture was mostly adhesive in nature. CONCLUSION Self-adhesive resin and resin-modified glass ionomer cement had better mechanical properties to retain implant supported restorations.
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Affiliation(s)
- Mhammad Saleh
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkish Republic of Northern Cyprus
| | - Simge Taşar-Faruk
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkish Republic of Northern Cyprus
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Matzkies LM, Raggam RB, Flick H, Rabensteiner J, Feierl G, Hoenigl M, Prattes J. Prognostic and diagnostic potential of suPAR levels in pleural effusion. J Infect 2017; 75:465-467. [PMID: 28712936 DOI: 10.1016/j.jinf.2017.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/07/2017] [Accepted: 07/09/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Lucie-Marie Matzkies
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Reinhard Bernd Raggam
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Holger Flick
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Jasmin Rabensteiner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Gebhard Feierl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Martin Hoenigl
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; CBmed - Center for Biomarker Research in Medicine, Graz, Austria; Division of Infectious Diseases, Department of Medicine, University of California, San Diego, USA
| | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria; CBmed - Center for Biomarker Research in Medicine, Graz, Austria.
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