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Ebrahimi R, Nasri F, Kalantari T. Coagulation and Inflammation in COVID-19: Reciprocal Relationship between Inflammatory and Coagulation Markers. Ann Hematol 2024; 103:1819-1831. [PMID: 38349409 DOI: 10.1007/s00277-024-05630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/16/2024] [Indexed: 05/14/2024]
Abstract
The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), formerly known as 2019-nCoV. Numerous cellular and biochemical issues arise after COVID-19 infection. The severe inflammation that is caused by a number of cytokines appears to be one of the key hallmarks of COVID-19. Additionally, people with severe COVID-19 have coagulopathy and fulminant thrombotic events. We briefly reviewed the COVID-19 disease at the beginning of this paper. The inflammation and coagulation markers and their alterations in COVID-19 illness are briefly discussed in the parts that follow. Next, we talked about NETosis, which is a crucial relationship between coagulation and inflammation. In the end, we mentioned the two-way relationship between inflammation and coagulation, as well as the factors involved in it. We suggest that inflammation and coagulation are integrated systems in COVID-19 that act on each other in such a way that not only inflammation can activate coagulation but also coagulation can activate inflammation.
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Affiliation(s)
- Rasoul Ebrahimi
- Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Nasri
- Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Kalantari
- Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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2
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Toraih E, Hussein M, Anker A, Baah S, Pinion D, Jishu J, Sadakkadulla S, Case M, LaForteza A, Moroz K, Kandil E. Survival Outcomes of Medullary Thyroid Cancer With and Without Amyloid Deposition. Endocr Pract 2024; 30:311-318. [PMID: 38184237 DOI: 10.1016/j.eprac.2024.01.001] [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: 11/14/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Amyloid deposition within tumor stroma is a distinctive histologic feature of medullary thyroid cancer (MTC). However, its prognostic significance remains uncertain. We aimed to elucidate the impact of amyloid status on survival outcomes in a large cohort. METHODS The Surveillance, Epidemiology, and End Results registry was queried to identify patients diagnosed with MTC from 2000 to 2019. Patients with amyloid-positive (International Classification of Diseases for Oncology, third edition code 8345/3) and amyloid negative (International Classification of Diseases for Oncology, third edition code 8510/3) tumors were analyzed. Overall and disease-specific survival were compared between matched cohorts using Kaplan-Meier and Cox proportional hazards analyses. RESULTS Of the 2526 MTC patients, 511 of which were amyloid-positive and 2015 that were amyloid negative. Amyloid-positive patients displayed lower T stage (T3/4: 28% vs 85%, P < .001) and less extrathyroidal extension (11.3% vs 81.6%, P < .001). No difference in distant metastasis rate was observed between groups (14.5% vs 14.4%, P = .98). However, amyloid-positive patients showed a tendency for distal lymph node metastasis (1.2% vs 0.3%, P = .020). On univariate analysis, amyloid-positive status showed comparable overall survival times (mean 172.2 vs 177.8 months, P = .17), but a trend toward worse cancer-specific survival (hazard ratios [HR] = 1.31, 95% CI = 0.99-1.71, P = .051). After adjusting for covariates, amyloid deposition did not independently predict overall (HR = 1.15, 95% CI = 0.91-1.47, P = .25) or cancer-specific survival (HR = 1.30, 95% CI = 0.96-1.77, P = .09). Initiating therapy later than 1 month following diagnosis was associated with worse overall survival (HR = 1.25, 95% CI = 1.02-1.54, P = .029). CONCLUSIONS The presence of amyloid in MTC paradoxically associates with lower T stage yet exhibits a trend toward worse cancer-specific mortality. Amyloid deposition alone does not independently influence prognosis. Delayed treatment adversely impacted overall survival.
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Affiliation(s)
- Eman Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Mohammad Hussein
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Allison Anker
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Solomon Baah
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Dylan Pinion
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Jessan Jishu
- School of Medicine, Tulane University, New Orleans, Louisiana
| | | | - Madeline Case
- School of Medicine, Tulane University, New Orleans, Louisiana
| | | | - Krzysztof Moroz
- Department of Pathology and Laboratory Medicine, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Emad Kandil
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana
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Saura O, Luyt CE. Procalcitonin as a biomarker to guide treatments for patients with lower respiratory tract infections. Expert Rev Respir Med 2023; 17:651-661. [PMID: 37639716 DOI: 10.1080/17476348.2023.2251394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Lower respiratory tract infections are amongst the main causes for hospital/intensive care unit admissions and antimicrobial prescriptions. In order to reduce antimicrobial pressure, antibiotic administration could be optimized through procalcitonin-based algorithms. AREAS COVERED In this review, we discuss the performances of procalcitonin for the diagnosis and the management of community-acquired and ventilator-associated pneumonia. We provide up-to-date evidence and deliver clear messages regarding the purpose of procalcitonin to reduce unnecessary antimicrobial exposure. EXPERT OPINION Antimicrobial pressure and resulting antimicrobial resistances are a major public health issue as well as a daily struggle in the management of patients with severe infectious diseases, especially in intensive care units where antibiotic exposure is high. Procalcitonin-guided antibiotic administration has proven its efficacy in reducing unnecessary antibiotic use in lower respiratory tract infections without excess in mortality, hospital length of stay or disease relapse. Procalcitonin-guided algorithms should be implemented in wards taking care of patients with severe infections. However, procalcitonin performances are different regarding the setting of the infection (community versus hospital-acquired infections) the antibiotic management (start or termination of antibiotic) as well as patient's condition (immunosuppressed or in shock) and we encourage the physicians to be aware of these limitations.
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Affiliation(s)
- Ouriel Saura
- Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles-Edouard Luyt
- Médecine Intensive Réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM, UMRS_1166, ICAN Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France
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Masetto T, Matzenbach K, Reuschel T, Tölke SA, Schneider K, Esser LM, Reinhart M, Bindila L, Peter C, Grimmler M. Comprehensive Comparison of the Capacity of Functionalized Sepharose, Magnetic Core, and Polystyrene Nanoparticles to Immuno-Precipitate Procalcitonin from Human Material for the Subsequent Quantification by LC-MS/MS. Int J Mol Sci 2023; 24:10963. [PMID: 37446139 DOI: 10.3390/ijms241310963] [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: 06/02/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The fast and accurate diagnosis of sepsis by procalcitonin (PCT) has emerged as an essential tool in clinical medicine. Although in use in the clinical laboratory for a long time, PCT quantification has not yet been standardized. The International Federation of Clinical Chemistry working group on the standardization of PCT (IFCC-WG PCT) aims to provide an LC-MS/MS-based reference method as well as the highest metrological order reference material to address this diagnostic need. Here, we present the systematic evaluation of the efficiency of an immuno-enrichment method, based on functionalized Sepharose, magnetic-core, or polystyrene (latex) nano-particles, to quantitatively precipitate PCT from different human sample materials. This method may be utilized for both mass spectrometric and proteomic purposes. In summary, only magnetic-core nano-particles functionalized by polyclonal PCT antibodies can fulfil the necessary requirements of the international standardization of PCT. An optimized method proved significant benefits in quantitative and specific precipitation as well as in the subsequent LC-MS/MS detection of PCT in human serum samples or HeLa cell extract. Based on this finding, further attempts of the PCT standardization process will utilize a magnetic core-derived immuno-enrichment step, combined with subsequent quantitative LC-MS/MS detection.
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Affiliation(s)
- Thomas Masetto
- Institute of Molecular Medicine I, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
- DiaSys Diagnostic Systems GmbH, Alte Straße 9, 65558 Holzheim, Germany
| | - Kai Matzenbach
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
| | - Thomas Reuschel
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
| | - Sebastian-Alexander Tölke
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
- Clinical Lipidomics Unit, Institute of Physiological Chemistry, University Medical Center, 55131 Mainz, Germany
| | - Klaus Schneider
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
| | - Lea Marie Esser
- Institute of Molecular Medicine I, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | | | - Laura Bindila
- Clinical Lipidomics Unit, Institute of Physiological Chemistry, University Medical Center, 55131 Mainz, Germany
| | - Christoph Peter
- Institute of Molecular Medicine I, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Matthias Grimmler
- DiaSys Diagnostic Systems GmbH, Alte Straße 9, 65558 Holzheim, Germany
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Limburger Straße 2, 65510 Idstein, Germany
- DiaServe Laboratories GmbH, Seeshaupter Straße 27, 82393 Iffeldorf, Germany
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Labandeira CM, Pedrosa MA, Suarez-Quintanilla JA, Cortes-Ayaso M, Labandeira-García JL, Rodríguez-Pérez AI. Angiotensin System Autoantibodies Correlate With Routine Prognostic Indicators for COVID-19 Severity. Front Med (Lausanne) 2022; 9:840662. [PMID: 35355599 PMCID: PMC8959920 DOI: 10.3389/fmed.2022.840662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
Objective We previously showed that angiotensin type-1 receptor and ACE2 autoantibodies (AT1-AA, ACE2-AA) are associated with COVID-19 severity. Our aim is to find correlations of these autoantibodies with routine biochemical parameters that allow an initial classification of patients. Methods In an initial cohort of 119 COVID-19 patients, serum AT1-AA and ACE2-AA concentrations were obtained within 24 h after diagnosis. In 50 patients with a complete set of routine biochemical parameters, clinical data and disease outcome information, a Random Forest algorithm was used to select prognostic indicators, and the Spearman coefficient was used to analyze correlations with AT1-AA, ACE2-AA. Results Hemoglobin, lactate dehydrogenase and procalcitonin were selected. A decrease in one unit of hemoglobin, an increase in 0.25 units of procalcitonin, or an increase in 100 units of lactate dehydrogenase increased the severity of the disease by 35.27, 69.25, and 3.2%, respectively. Our binary logistic regression model had a predictive capability to differentiate between mild and moderate/severe disease of 84%, and between mild/moderate and severe disease of 76%. Furthermore, the selected parameters showed strong correlations with AT1-AA or ACE2-AA, particularly in men. Conclusion Hemoglobin, lactate dehydrogenase and procalcitonin can be used for initial classification of COVID-19 patients in the admission day. Subsequent determination of more complex or late arrival biomarkers may provide further data on severity, mechanisms, and therapeutic options.
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Affiliation(s)
- Carmen M Labandeira
- Hospital Alvaro Cunqueiro, University Hospital Complex, Vigo, Spain.,Research Center for Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria A Pedrosa
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan A Suarez-Quintanilla
- Primary Health-Care Unit Fontiñas, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Cortes-Ayaso
- Emergency Department, University Clinical Hospital of Santiago, Santiago de Compostela, Spain
| | - José Luis Labandeira-García
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ana I Rodríguez-Pérez
- Research Center for Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
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Pişkinpaşa ME. The Role of Presepsin in Predicting Severe Coronavirus Disease-2019 Pneumonia Prognosis. ISTANBUL MEDICAL JOURNAL 2022. [DOI: 10.4274/imj.galenos.2022.96646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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7
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Xiang S, Tan J, Tan C, Xu Q, Wen Y, Wang T, Yang C, Zhao W. Establishment and Validation of a Non-Invasive Diagnostic Nomogram to Identify Spontaneous Bacterial Peritonitis in Patients With Decompensated Cirrhosis. Front Med (Lausanne) 2022; 8:797363. [PMID: 35174183 PMCID: PMC8842661 DOI: 10.3389/fmed.2021.797363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/20/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Spontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with decompensated cirrhosis (DC), and it is accompanied with high mortality and morbidity. However, early diagnosis of spontaneous bacterial peritonitis (SBP) is not possible because of the lack of typical symptoms or the low patient compliance and positivity rate of the ascites puncture test. We aimed to establish and validate a non-invasive diagnostic nomogram to identify SBP in patients with DC. METHOD Data were collected from 4,607 patients with DC from July 2015 to December 2019 in two tertiary hospitals in Chongqing, China (A and B). Patients with DC were divided into the SBP group (995 cases) and the non-SBP group (3,612 cases) depending on whether the patients had SBP during hospitalization. About 70% (2,685 cases) of patients in hospital A were randomly selected as the traindata, and the remaining 30% (1,152 cases) were used as the internal validation set. Patients in hospital B (770 cases) were used as the external validation set. The univariate analysis and least absolute shrinkage and selection operator (LASSO) regression were used to screen variables, and logistic regression was used to determine independent predictors to construct a nomogram to identify patients with SBP. Area under curve (AUC), calibration curve, and dynamic component analysis (DCA) were carried out to determine the effectiveness of the nomogram. RESULT The nomogram was composed of seven variables, namely, mean red blood cell hemoglobin concentration (odds ratio [OR] = 1.010, 95% CI: 1.004-1.016), prothrombin time (OR = 1.038, 95% CI: 1.015-1.063), lymphocyte percentage (OR = 0.955, 95% CI: 0.943-0.967), prealbumin (OR = 0.990, 95% CI: 0.987-0.993), total bilirubin (OR = 1.003 95% CI: 1.002-1.004), abnormal C-reactive protein (CRP) level (OR = 1.395, 95% CI: 1.107-1.755), and abnormal procalcitonin levels (OR = 1.975 95% CI: 1.522-2.556). Good discrimination of the model was observed in the internal and external validation sets (AUC = 0.800 and 0.745, respectively). The calibration curve result indicated that the nomogram was well-calibrated. The DCA curve of the nomogram presented good clinical application ability. CONCLUSION This study identified the independent risk factors of SBP in patients with DC and used them to construct a nomogram, which may provide clinical reference information for the diagnosis of SBP in patients with DC.
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Affiliation(s)
- Shoushu Xiang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Juntao Tan
- Department of Medical Administration, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Chao Tan
- Cancer Hospital, Chongqing University, Chongqing, China
| | - Qian Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Yuanjiu Wen
- Department of General Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Tiantian Wang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Chen Yang
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Wenlong Zhao
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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8
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Baranowsky A, Jahn D, Jiang S, Yorgan T, Ludewig P, Appelt J, Albrecht KK, Otto E, Knapstein P, Donat A, Winneberger J, Rosenthal L, Köhli P, Erdmann C, Fuchs M, Frosch KH, Tsitsilonis S, Amling M, Schinke T, Keller J. Procalcitonin is expressed in osteoblasts and limits bone resorption through inhibition of macrophage migration during intermittent PTH treatment. Bone Res 2022; 10:9. [PMID: 35087025 PMCID: PMC8795393 DOI: 10.1038/s41413-021-00172-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 07/01/2021] [Accepted: 08/10/2021] [Indexed: 12/13/2022] Open
Abstract
Intermittent injections of parathyroid hormone (iPTH) are applied clinically to stimulate bone formation by osteoblasts, although continuous elevation of parathyroid hormone (PTH) primarily results in increased bone resorption. Here, we identified Calca, encoding the sepsis biomarker procalcitonin (ProCT), as a novel target gene of PTH in murine osteoblasts that inhibits osteoclast formation. During iPTH treatment, mice lacking ProCT develop increased bone resorption with excessive osteoclast formation in both the long bones and axial skeleton. Mechanistically, ProCT inhibits the expression of key mediators involved in the recruitment of macrophages, representing osteoclast precursors. Accordingly, ProCT arrests macrophage migration and causes inhibition of early but not late osteoclastogenesis. In conclusion, our results reveal a potential role of osteoblast-derived ProCT in the bone microenvironment that is required to limit bone resorption during iPTH.
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Affiliation(s)
- Anke Baranowsky
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany.,Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Denise Jahn
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Shan Jiang
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Timur Yorgan
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Peter Ludewig
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, 20251, Germany
| | - Jessika Appelt
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Kai K Albrecht
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Ellen Otto
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Paul Knapstein
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Antonia Donat
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Jack Winneberger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, 20251, Germany
| | - Lana Rosenthal
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Paul Köhli
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Cordula Erdmann
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Melanie Fuchs
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Karl-Heinz Frosch
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Serafeim Tsitsilonis
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany.,Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, 13353, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Johannes Keller
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany. .,Berlin Institute of Health, Berlin, 10178, Germany.
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Neumann S, Steingräber L, Herold L. Investigation of procalcitonin and beta-defensin2 in the serum and feces of dogs with acute diarrhea. Vet Clin Pathol 2022; 50 Suppl 1:55-62. [PMID: 35040162 DOI: 10.1111/vcp.13099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Acute diarrhea is a common clinical condition where clinical parameters are used to assess disease severity, course, and prognosis. OBJECTIVES The aim of this study was to investigate procalcitonin (PCT) and beta-defensin2 (Bdef2) as biomarkers for disease severity, course, and prognosis of dogs with acute diarrhea. METHODS Dogs with acute diarrhea (enteritis group [EG], n = 35) were compared with 30 healthy controls. The dogs in the EG were scored using the Canine Acute Diarrhea Severity (CADS) index and grouped by bacterial fecal culture results. Procalcitonin and Bdef2 were analyzed in serum and feces. RESULTS Dogs with acute diarrhea showed higher serum PCT concentrations (P < 0.0001) and lower fecal Bdef2 concentrations (P = 0.0001) than unaffected dogs. Serum PCT was moderately and positively related to the extent of disease classified by the CADS score. Dogs with Clostridium perfringens or hemolyzing Escherichia coli as predominant pathogen had increased serum Bdef2 concentrations (P < 0.01). Differentiation between uncomplicated (≤3 days) and complicated (>3 days) disease courses, determined by receiver operating characteristic (ROC) curves, resulted in a sensitivity of 0.74 and a specificity of 0.69 for serum PCT at a cutoff of 3.9 ng/mL. The serum PCT and fecal Bdef2 quotient resulted in a sensitivity of 0.80 and a specificity of 0.92, with a cutoff of 80.5. CONCLUSIONS The results of the present study indicate that PCT and Bdef2 are potential biomarkers that can provide information on the severity, course, and prognosis of acute diarrhea in dogs.
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Affiliation(s)
- Stephan Neumann
- Institute of Veterinary Medicine, University of Göttingen, Göttingen, Germany
| | - Lilith Steingräber
- Institute of Veterinary Medicine, University of Göttingen, Göttingen, Germany
| | - Lisa Herold
- Institute of Veterinary Medicine, University of Göttingen, Göttingen, Germany
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Wang H, Wang M, Chi H, Zhang S, Wang Y, Wu D, Wei Q. Sandwich-type photoelectrochemical immunosensor for procalcitonin detection based on Mn 2+ doped CdS sensitized Bi 2WO 6 and signal amplification of NaYF 4:Yb, Tm upconversion nanomaterial. Anal Chim Acta 2021; 1188:339190. [PMID: 34794572 DOI: 10.1016/j.aca.2021.339190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 12/01/2022]
Abstract
In this paper, we constructed a sandwich-type photoelectrochemical (PEC) immunosensor for the quantitative detection of procalcitonin (PCT) based on the sensitization of Mn2+ doped CdS (CdS:Mn) nanocomposites to Bi2WO6 and the signal amplification effect of an upconversion material NaYF4:Yb,Tm. Bi2WO6 was synthesized with a three-dimensional flowered structure. CdS:Mn reduced the recombination of photogenerated carriers, and significantly improved photocurrent response. Lanthanide-doped upconversion nanomaterials were used as the label of secondary antibody. NaYF4:Yb,Tm have two functions, not only connected with the secondary antibody, but also can further amplify the photocurrent response. The proposed immunosensor for detecting PCT provided a desired linear range of 0.5 pg mL-1-100 ng mL-1 and a detection limit of 0.13 pg mL-1 under optimal experimental conditions. Besides, the PEC immunosensor demonstrated good reproducibility, specificity and stability. The results of determination of PCT in real human serum samples were satisfactory. Thus, the immunosensor may be applied in the clinical diagnosis of PCT and other biomarkers.
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Affiliation(s)
- Hui Wang
- Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, 250022, China
| | - Meng Wang
- Hand and Foot Surgery Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China
| | - Huitong Chi
- Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, 250022, China
| | - Shitao Zhang
- Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, 250022, China
| | - Yaoguang Wang
- Shandong Provincial Key Laboratory of Molecular Engineering, School of Chemistry and Chemical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Dan Wu
- Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, 250022, China.
| | - Qin Wei
- Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, 250022, China
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11
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Electrochemical Immunosensors for Quantification of Procalcitonin: Progress and Prospects. CHEMOSENSORS 2021. [DOI: 10.3390/chemosensors9070182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Human procalcitonin (PCT) is a peptide precursor of the calcium-regulating hormone calcitonin. Traditionally, PCT has been used as a biomarker for severe bacterial infections and sepsis. It has also been recently identified as a potential marker for COVID-19. Normally, serum PCT is intracellularly cleaved to calcitonin, which lowers the levels of PCT (<0.01 ng/mL). In severe infectious diseases and sepsis, serum PCT levels increase above 100 ng/mL in response to pro-inflammatory stimulation. Development of sensors for specific quantification of PCT has resulted in considerable improvement in the sensitivity, linear range and rapid response. Among the various sensing strategies, electrochemical platforms have been extensively investigated owing to their cost-effectiveness, ease of fabrication and portability. Sandwich-type electrochemical immunoassays based on the specific antigen–antibody interactions with an electrochemical transducer and use of nanointerfaces has augmented the electrochemical response of the sensors towards PCT. Identification of a superior combination of electrode material and nanointerface, and translation of the sensing platform into flexible and disposable substrates are under active investigation towards development of a point-of-care device for PCT detection. This review provides an overview of the existing detection strategies and limitations of PCT electrochemical immunosensors, and the emerging directions to address these lacunae.
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12
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Shen Y, Cheng C, Zheng X, Jin Y, Duan G, Chen M, Chen S. Elevated Procalcitonin Is Positively Associated with the Severity of COVID-19: A Meta-Analysis Based on 10 Cohort Studies. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:594. [PMID: 34207689 PMCID: PMC8227321 DOI: 10.3390/medicina57060594] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022]
Abstract
Background and Objectives: Procalcitonin (PCT) is positively associated with the severity of COVID-19 (including severe, critical, or fatal outcomes), but some of the confounding factors are not considered. The aim of this meta-analysis was to estimate the adjusted relationship between elevated procalcitonin on admission and the severity of COVID-19. Materials and Methods: We searched 1805 articles from PubMed, Web of Science, and Embase databases up to 2 April 2021. The articles were selected which reported the adjusted relationship applying multivariate analysis between PCT and the severity of COVID-19. The pooled effect estimate was calculated by the random-effects model. Results: The meta-analysis included 10 cohort studies with a total of 7716 patients. Patients with elevated procalcitonin on admission were at a higher risk of severe and critical COVID-19 (pooled effect estimate: 1.77, 95% confidence interval (CI): 1.38-2.29; I2 = 85.6%, p < 0.001). Similar results were also observed in dead patients (pooled effect estimate: 1.77, 95% CI: 1.36-2.30). After adjusting for diabetes, the positive association between PCT and the severity of COVID-19 decreased. Subgroup analysis revealed heterogeneity between studies and sensitivity analysis showed that the results were robust. There was no evidence of publication bias by Egger's test (p = 0.106). Conclusions: Higher procalcitonin is positively associated with the severity of COVID-19, which is a potential biomarker to evaluate the severity of COVID-19 and predict the prognosis.
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Affiliation(s)
- Yue Shen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
| | - Xue Zheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
| | - Yuefei Jin
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
| | - Guangcai Duan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
| | - Mengshi Chen
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha 410078, China;
| | - Shuaiyin Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (Y.S.); (C.C.); (X.Z.); (Y.J.); (G.D.)
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13
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Barbieri E, Rossin S, Giaquinto C, Da Dalt L, Dona’ D. A Procalcitonin and C-Reactive Protein-Guided Clinical Pathway for Reducing Antibiotic Use in Children Hospitalized with Bronchiolitis. CHILDREN (BASEL, SWITZERLAND) 2021; 8:351. [PMID: 33925182 PMCID: PMC8146464 DOI: 10.3390/children8050351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/16/2021] [Accepted: 04/25/2021] [Indexed: 11/16/2022]
Abstract
Despite the lack of evidence that bronchodilators, corticosteroids, and antibiotics are useful in treating bronchiolitis, their use is still widespread. This study aimed to determine the consumption of antibiotics for bronchiolitis before and after a procalcitonin-guided clinical pathway (CP) implementation. In December 2019, a CP for lower respiratory tract infection management was implemented at the Department of Women's and Children's Health at Padua University Hospital. This was a pre-post, quasi-experimental study that assessed the changes in the treatment of bronchiolitis during two bimesters preceding the CP implementation (pre-period: January 2018-February 2018 and January 2019-February 2019) and during the bimester after CP implementation (post-period January 2020-February 2020). After the CP implementation, there was a significant reduction in antibiotic prescriptions from 36.2% to 12.5% (p = 0.036) in patients hospitalized for bronchiolitis. Co-amoxiclav treatment, the antibiotic most commonly administered, decreased from 66.6% to 33.3%. Among outpatients' bronchiolitis episodes, a statistically significant decrease in beta2-agonists' use (from 18.0% to 4.4%, pre and post periods) and a quasi-significant decrease in corticosteroid use (from 8.0% to 0% pre and post periods) were observed. An evidence-based CP supported by educational lectures was associated with significant changes in the physicians' prescribing habits.
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Affiliation(s)
- Elisa Barbieri
- Division of Paediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, 35100 Padova, Italy; (C.G.); (D.D.)
| | - Sara Rossin
- Pediatric Emergency Department, Department of Women’s and Children’s Health, University Hospital of Padova, 35100 Padova, Italy; (S.R.); (L.D.D.)
| | - Carlo Giaquinto
- Division of Paediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, 35100 Padova, Italy; (C.G.); (D.D.)
| | - Liviana Da Dalt
- Pediatric Emergency Department, Department of Women’s and Children’s Health, University Hospital of Padova, 35100 Padova, Italy; (S.R.); (L.D.D.)
| | - Daniele Dona’
- Division of Paediatric Infectious Diseases, Department of Women’s and Children’s Health, University of Padova, 35100 Padova, Italy; (C.G.); (D.D.)
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14
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Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci 2020; 57:389-399. [PMID: 32503382 PMCID: PMC7284147 DOI: 10.1080/10408363.2020.1770685] [Citation(s) in RCA: 475] [Impact Index Per Article: 118.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.
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Affiliation(s)
- Giovanni Ponti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Division of Clinical Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Monia Maccaferri
- Dermatology Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Cristel Ruini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Division of Clinical Pathology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - Aldo Tomasi
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Division of Clinical Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Tomris Ozben
- Department of Clinical Biochemistry, Medical Faculty, Akdeniz University, Antalya, Turkey
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15
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Kilcoyne I, Nieto JE, Dechant JE. Diagnostic value of plasma and peritoneal fluid procalcitonin concentrations in horses with strangulating intestinal lesions. J Am Vet Med Assoc 2020; 256:927-933. [PMID: 32223710 DOI: 10.2460/javma.256.8.927] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the diagnostic value of plasma and peritoneal fluid procalcitonin concentrations for identification of horses with strangulating intestinal lesions. ANIMALS 65 horses with signs of colic of intestinal origin and 10 healthy (control) horses. PROCEDURES For each horse, plasma and peritoneal fluid samples were obtained for a CBC and determination of total protein, procalcitonin, and lactate concentrations. Signalment and clinicopathologic findings were compared among control horses and horses with strangulating and nonstrangulating intestinal lesions. RESULTS Mean ± SD plasma (274.9 ± 150.8 pg/mL) and peritoneal fluid (277 ± 50.6 pg/mL) procalcitonin concentrations for horses with colic were significantly greater than the mean ± SD plasma (175.5 ± 46.0 pg/mL) and peritoneal fluid (218.8 ± 48.7 pg/mL) procalcitonin concentrations for control horses. Mean procalcitonin concentration in peritoneal fluid, but not plasma, differed significantly between horses with strangulating lesions and those with nonstrangulating lesions. A peritoneal fluid procalcitonin concentration ≥ 281.7 pg/mL had a sensitivity of 81%, specificity of 69%, positive predictive value of 56.7%, and negative predictive value of 87.9% for detection of strangulating lesions. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that peritoneal fluid procalcitonin concentration, when evaluated in conjunction with other clinicopathologic results, might be a sensitive indicator of intestinal ischemia and facilitate early identification of horses that require surgery to address a strangulating lesion.
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16
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Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits. Animals (Basel) 2020; 10:ani10091511. [PMID: 32859059 PMCID: PMC7552142 DOI: 10.3390/ani10091511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
Simple Summary Among sepsis biomarkers, procalcitonin resulted to be a specific indicator of bacterial infection or severity of infection, and to be a good control of the success of a therapeutic procedure. The clinical studies on the relevance of procalcitonin as a sepsis predictor in veterinary patients are few, likely due to the total absence of validated assays. For this reason, this study aimed to investigate commercial ELISA kits for the detection of canine and equine procalcitonin. Validation was performed evaluating linearity, limits of detection (LOD), recovery, and intra-assay and inter-assay variability; furthermore, clinical samples were analyzed. The results of the present study demonstrate that the human PCT ELISA kit is suitable to detect equine procalcitonin with a LOD of 56 ng/mL, and the canine recombinant PCT ELISA kit can be used to measure canine procalcitonin in plasma samples, showing an intra-assay and inter-assay coefficient of variation less than 20% and a LOD of 11 pg/mL. Abstract In human medicine, procalcitonin (PCT), the precursor of calcitonin, is used for the rapid identification of the origin and severity of sepsis. In veterinary medicine, PCT has been studied in horses, cattle, and dogs, but the use of PCT in diagnostic and/or prognostic settings is not possible because of the lack of validated assays to obtain reference ranges. The aim of the present study was the investigation of commercially available ELISA kits for the detection of canine and equine PCT in plasma samples. Validation of the ELISA kits was performed by using species-specific recombinant proteins spiked both in plasma and buffer samples; linearity, limit of detection (LOD), recovery, and intra-assay and inter-assay variability were calculated. Moreover, clinical samples obtained from sick and healthy animals were also analyzed with the tested kits. Canine PCT was measured with a recombinant canine and a canine PCT ELISA kit. Equine PCT was measured with an equine and a human ELISA PCT kit. Our data demonstrate that the canine recombinant PCT ELISA kit can be used to measure canine PCT in plasma samples, showing an intra-assay and inter-assay coefficient of variation less than 20% and a LOD of 11 pg/mL, whereas the present results do not support the use of the canine PCT ELISA kit. The human PCT ELISA kit is suitable to detect equine PCT with a LOD of 56 ng/mL, whereas the equine PCT ELISA kit did not detect recombinant equine PCT.
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17
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Easley F, Holowaychuk MK, Lashnits EW, Nordone SK, Marr H, Birkenheuer AJ. Serum procalcitonin concentrations in dogs with induced endotoxemia. J Vet Intern Med 2020; 34:653-658. [PMID: 31970837 PMCID: PMC7096631 DOI: 10.1111/jvim.15711] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background Procalcitonin (PCT) is an important biomarker for sepsis in human medicine, but there is little information regarding PCT as a biomarker for sepsis in dogs. There are no controlled studies evaluating serial concentrations of PCT in dogs. Hypothesis/Objective That PCT would be rapidly detectable in serum after injection of LPS and would remain increased for at least 24 hours. Objective was to evaluate serial serum PCT concentrations in dogs after a single IV injection of LPS compared to placebo. Animals Six healthy mixed breed dogs. Methods A nonrandomized, placebo‐controlled, crossover study was performed. Dogs were initially injected with placebo (0.9% NaCl; 1 mL, IV) and then experimental endotoxemia was induced by injecting lipopolysaccharide (LPS; 2 μg/kg, IV, once) after a 5‐day washout period. Serial blood samples were collected for measurement of serum PCT after each injection. Difference in median PCT concentration between serial time points was assessed using a mixed effects model. Results After LPS administration, blood pressure decreased and body temperature increased along with the development of lethargy, vomiting, and diarrhea. Procalcitonin was significantly increased compared to baseline by 2 hours after injection of LPS (median = 67.9 versus 172.8, range = 46.0‐74.1 versus 99.5‐295.9, P = .0002) and remained significantly increased for 12 hours (median = 205.9, range = 119.9‐297.4) with return to baseline by 48 hours. Procalcitonin was significantly higher than placebo 2, 4, 6, 8, 10, 12, and 24 hours after injection. There were no significant differences in PCT between time 0 and any of the subsequent time points in the saline group. Conclusions and Clinical Importance Procalcitonin expression is likely to be a clinically useful biomarker for sepsis in dogs and might have an additional role in prognostication and therapeutic decision‐making.
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Affiliation(s)
- Frankie Easley
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | | | - Erin W Lashnits
- North Carolina State University College of Veterinary Medicine, Comparative Biomedical Sciences, Raleigh, North Carolina
| | - Shila K Nordone
- Department of Molecular Biomedical Sciences, Comparative Medicine Institute, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | - Henry Marr
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | - Adam J Birkenheuer
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
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18
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Shirali AS, Wu JX, Zhu CY, Ocampo A, Tseng CH, Du L, Livhits MJ, Leung AM, Yeh MW. The Role of Serum Procalcitonin in Predicting Bacterial Sepsis in Patients With Hypothyroidism. J Clin Endocrinol Metab 2019; 104:5915-5922. [PMID: 31361312 DOI: 10.1210/jc.2019-01082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/24/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Serum levels of procalcitonin (PCT), a protein produced by the thyroid C cells under physiologic conditions, are high during sepsis. OBJECTIVE To assess the test performance of serum PCT in predicting bacterial sepsis and septic shock in patients with hypothyroidism compared with those who have euthyroidism. DESIGN AND METHODS This retrospective study evaluated patients with no history of thyroid dysfunction (euthyroid), primary hypothyroidism [medical hypothyroidism (MH)], and postsurgical hypothyroidism from total thyroidectomy (TT) identified from a prospectively maintained database who had PCT testing from 2005 to 2018. Quick Sequential Organ Failure Assessment score ≥ 2 or positive bacterial cultures identified bacterial sepsis, and a mean arterial pressure less than 65 mm Hg or a vasopressor requirement defined septic shock. Sensitivity and specificity of PCT for evaluation of bacterial sepsis and septic shock were measured. RESULTS We identified 217 euthyroid patients, 197 patients with MH, and 84 patients with TT. Bacterial sepsis was found in 98 (45.2%), 92 (46.7%), and 36 (42.9%) of these patients, respectively (P > 0.05). Septic shock was identified in 13 (6.0%), 13 (6.6%), and 5 (6.0%) patients (P > 0.05), respectively. With use of a PCT cutoff of 0.5 µg/L for bacterial sepsis, the sensitivity was 59%, 61%, and 53% (P > 0.05) and specificity was 81%, 77%, and 81% (P > 0.05) for the diagnosis of bacterial sepsis in euthyroid, MH, and TT patients, respectively. With use of a PCT cutoff of 2.0 µg/L for septic shock, the sensitivity was 46%, 62%, and 63% (P > 0.05) and specificity was 86%, 82%, and 91% (P > 0.05) for the diagnosis of septic shock in these patients, respectively. CONCLUSIONS Despite the thyroidal origin of PCT, hypothyroidism did not affect the diagnostic performance of serum PCT levels in predicting bacterial sepsis or septic shock.
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Affiliation(s)
- Aditya S Shirali
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - James X Wu
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Catherine Y Zhu
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Alfonso Ocampo
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Chi-Hong Tseng
- Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Lin Du
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Masha J Livhits
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Angela M Leung
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Michael W Yeh
- Section of Endocrine Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
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C Reactive Protein and Procalcitonine as Diagnostic Markers in Critically Ill Patients with Suspected Sepsis. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The primary aim of this retrospective study was to estimate significance of determining C-reactive protein and procalcitonine for a diagnosis of sepsis in adult patients in early triage. Also, the aim of this study was to measure the sensitivity of the SIRS criteria, PCT and CRP levels and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the Emergency Department (ED) triage. All patients were divided into two groups according to specific criteria for defining sepsis. First group (SIRS+ group) of patients were patients with clinically and/or laboratory confirmed sepsis (or systemic inflammatory response syndrome (SIRS) to bacterial infection with different localization). For confirmation of the SIRS we consider positive two or more clinical criteria (≥2 clinical criteria). The SIRS criteria use the clinical criteria of the Surviving Sepsis Campaign (SSC) for the SIRS, comprising at least two of the following criteria: HR > 90/min, RR > 20/min and temperature < 36° or ≥ 38.3°C and the next laboratory parameters such as leucocytosis > 15x109/L, leucopenia < 4x109/L, > 10% immature leucocytes. Second group of patients were patients with the SIRS negative criteria as a diagnostic tool (SIRS- group). We have founded that the CRP showed high sensitivity but no specificity in patients with sepsis, but on the other side, the PCT as a diagnostic marker showed a high sensitivity and high specificity in these patients. Also, the PCT is in positive correlation with the SIRS criteria, which could be of a clinical significance in early diagnosis of septic infections.
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Aloisio E, Dolci A, Panteghini M. Procalcitonin: Between evidence and critical issues. Clin Chim Acta 2019; 496:7-12. [PMID: 31194966 DOI: 10.1016/j.cca.2019.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 12/15/2022]
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated response of the host to infection. It represents one of the major health care problems worldwide. Unfortunately, the diagnosis of sepsis is challenging for many reasons, including a lack of a sufficiently sensitive and specific diagnostic test. When procalcitonin (PCT) was discovered, it was thought that it could become the best test for identifying patients with sepsis. From the evidence sources in the available literature, it is now clear that the power of PCT in differentiating infectious from non-infectious forms of systemic inflammatory response syndrome in adults, and in stratifying morbidity and mortality risk, is limited. Nevertheless, PCT determination can be a useful tool for diagnosing late-onset neonatal sepsis, bacterial meningitis and other forms of organ-related bacterial infections and, above all, it can be used for guiding antibiotic stewardship in critical patients. The real impact of this application of PCT testing, however, still needs to be clearly defined. Laboratories should offer unrestricted PCT testing only to intensive care units (as an aid in decision for continuing or stopping antibiotics) and pediatric wards. For all other clinical wards, the laboratory should guide PCT requests and give them support towards the most appropriate approach to testing.
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Affiliation(s)
- Elena Aloisio
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy.
| | - Alberto Dolci
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - Mauro Panteghini
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
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21
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Endogenous calcitonin regulates lipid and glucose metabolism in diet-induced obesity mice. Sci Rep 2018; 8:17001. [PMID: 30451912 PMCID: PMC6242993 DOI: 10.1038/s41598-018-35369-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/05/2018] [Indexed: 12/22/2022] Open
Abstract
Calcitonin (CT) plays an important role in calcium homeostasis, and its precursor, proCT, is positively associated with the body mass index in the general human population. However, the physiological role of endogenous CT in the regulation of metabolism remains unclear. Knockout mice with gene-targeted deletion of exon 4 of Calca (CT KO) were generated by targeted modification in embryonic stem cells. Male mice were used in all experiments and were fed a slightly higher fat diet than the standard diet. The CT KO mice did not exhibit any abnormal findings in appearance, but exhibited weight loss from 15 months old, i.e., significantly decreased liver, adipose tissue, and kidney weights, compared with wild-type control mice. Furthermore, CT KO mice exhibited significantly decreased fat contents in the liver, lipid droplets in adipose tissues, serum glucose, and lipid levels, and significantly increased insulin sensitivity and serum adiponectin levels. CT significantly promoted 3T3-L1 adipocyte differentiation and suppressed adiponectin release. These results suggested that CT gene deletion prevents obesity, hyperglycemia, and hyperlipidemia in aged male mice. This is the first definitive evidence that CT may contribute to glucose and lipid metabolism in aged male mice, possibly via decreased adiponectin secretion from adipocytes.
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22
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Aljabi Y, Manca A, Ryan J, Elshawarby A. Value of procalcitonin as a marker of surgical site infection following spinal surgery. Surgeon 2018; 17:97-101. [PMID: 30055952 DOI: 10.1016/j.surge.2018.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/20/2018] [Accepted: 05/28/2018] [Indexed: 11/19/2022]
Abstract
AIM To compare the value of Procalcitonin (PCT) as a marker of surgical site infection to other inflammatory markers, including C-Reactive Protein (CRP), White Cell Count (WCC) and Erythrocyte Sedimentation Rate (ESR) in patients undergoing a number of spinal procedures. This study also aims to describe the biokinetic profile of the above-named markers in patients developing surgical site infection and those remaining infection-free post-operatively. METHODS 200 patients undergoing four routine elective spinal procedures were included for analysis. All patients had blood specimens taken at baseline, day 1, 2, 3, 4 and 5 post-operatively for analysis of PCT, CRP, ESR and WCC levels. All patients were monitored for early surgical site infection. Patients with other sources of infection in the early postoperative period were excluded. RESULTS Procalcitonin was the most sensitive and specific marker for the detection of surgical site infection in the immediate post-operative period with sensitivity and specificity of 100% and 95.2% respectively. Although Procalcitonin is an inflammatory marker, extent of surgical physiological insult did not alter its biokinetics as opposed to the other inflammatory markers making it a valuable marker of infection. CONCLUSION Procalcitonin was found to be superior to the other inflammatory markers investigated in this study as a marker for early surgical site infection in patients undergoing spinal surgery.
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Affiliation(s)
- Yasser Aljabi
- Department of Spinal Surgery, Tawam Hospital in affiliation with Johns Hopkins Medical, Al Ain, United Arab Emirates; Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland.
| | - Angelo Manca
- Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Jessica Ryan
- Department of Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Amr Elshawarby
- Department of Spinal Surgery, Tawam Hospital in affiliation with Johns Hopkins Medical, Al Ain, United Arab Emirates
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23
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Abstract
Researchers estimate the incidence of early onset sepsis as 0.77-1/1,000 live births. It remains as one of the leading causes of neonatal deaths. Clinicians and researchers continue to search for biomarkers for specific neonatal disease processes. Clinicians frequently trend C-reactive protein levels during evaluation for neonatal sepsis. Recently, researchers have begun to explore procalcitonin as a potentially useful diagnostic marker for neonatal sepsis.
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Goggs R, Milloway M, Troia R, Giunti M. Plasma procalcitonin concentrations are increased in dogs with sepsis. Vet Rec Open 2018; 5:e000255. [PMID: 29682292 PMCID: PMC5905832 DOI: 10.1136/vetreco-2017-000255] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/23/2018] [Accepted: 03/08/2018] [Indexed: 11/03/2022] Open
Abstract
Sepsis, the life-threatening organ dysfunction caused by a dysregulated host response to infection, is difficult to identify and to prognosticate for. In people with sepsis, procalcitonin (PCT) measurement aids diagnosis, enables therapeutic monitoring and improves prognostic accuracy. This study used a commercial canine PCT assay to measure plasma PCT concentrations in dogs with gastric dilatation volvulus (GDV) syndrome and in dogs with sepsis. It was hypothesised that dogs with GDV syndrome and with sepsis have greater plasma PCT concentrations than healthy dogs and that dogs with sepsis have greater PCT concentrations than dogs with GDV syndrome. Before analysing canine plasma samples, the ability of the assay to identify canine PCT, in addition to assay imprecision and the lower limit of detection were established. The assay had low imprecision with coefficients of variation ≤4.5 per cent. The lower limit of detection was 3.4 pg/ml. Plasma PCT concentrations were measured in 20 dogs with sepsis, in 32 dogs with GDV syndrome and in 52 healthy dogs. Median (IQR) PCT concentration in dogs with sepsis 78.7 pg/ml (39.1-164.7) was significantly greater than in healthy dogs 49.8 pg/ml (36.2-63.7) (P=0.019), but there were no significant differences between PCT concentrations in dogs with GDV syndrome and controls (P=0.072) or between dogs with sepsis and GDV syndrome (P=1.000). Dogs with sepsis have significantly increased plasma PCT concentrations compared with healthy dogs, although considerable overlap between these populations was identified. Future investigations should confirm this finding in other populations and evaluate the diagnostic and prognostic value of PCT in dogs with sepsis.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York City, USA
| | - Matthew Milloway
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York City, USA
| | - Roberta Troia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Development and Validation of an Ultrasensitive Procalcitonin Sandwich Immunoassay. High Throughput 2017; 6:ht6040018. [PMID: 29479055 PMCID: PMC5748597 DOI: 10.3390/ht6040018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 12/18/2022] Open
Abstract
Procalcitonin (PCT) is well established as a highly specific biomarker for the detection of bacterial infections and sepsis. However, the currently available diagnostic tests are not able to detect very low or very early increases of PCT or even baseline levels in healthy individuals or patients with non-bacterial infections. In order to be able to detect these very low concentrations of PCT, a sandwich immunoassay was developed using high sensitivity Single Molecule Array technology (Simoa). The assay was thoroughly validated and applied to analyze human cerebrospinal fluid (CSF) and serum samples from patients with bacterial or viral meningitis as well as CSF, serum, and K2 EDTA plasma from healthy control subjects. A 50-fold increase in sensitivity compared to the current gold standard assays was achieved, which was sensitive enough for the detection of baseline PCT levels. Both serum and CSF showed significantly elevated PCT levels in patients with bacterial meningitis compared to patients with viral meningitis and the healthy control group. Procalcitonin concentration levels for patients with viral meningitis and the control group could be measured, but were not significantly different. The determination of PCT in the low pg·mL−1 range could help to improve the monitoring of bacterial infectious diseases, as PCT level changes could be detected earlier.
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Abstract
Peptide hormones represent a major class of hormones that are made from amino acids by specialized endocrine glands. The maturation of bioactive hormones take place in the rough endoplasmic reticulum and Golgi apparatus, where preprohormones are proteolytically cleaved into prohormones, and subsequently into mature peptide hormones. Once the bioactive hormones are released into the circulation, they interact with receptors located on the plasma membrane of target cells, and initiate intracellular signaling pathways to regulate physiological processes including energy metabolism, growth, stress, and reproduction. However, excessive amount of circulating peptide hormones often associates with the presence of tumors. Section 2 discusses 10 peptide hormones as tumor markers and their clinical application in aiding the diagnosis of tumors as well as monitoring the disease process.
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Affiliation(s)
- Qian Sun
- National Institutes of Health, Bethesda, MD, United States
| | - Zhen Zhao
- National Institutes of Health, Bethesda, MD, United States.
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Zielińska-Borkowska U, Dib N, Tarnowski W, Skirecki T. Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery. Clin Chem Lab Med 2017; 55:1053-1059. [PMID: 27930362 DOI: 10.1515/cclm-2016-0736] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/01/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Early recognition of patients who have developed anastomotic leakage (AL) after colorectal surgery is crucial for the successful treatment of this complication. The aim of this study was to assess the usefulness of the assessment of procalcitonin (PCT) and interleukin-6 (IL-6) levels in the prognosis of AL. METHODS This observational study included 157 patients who underwent major elective colorectal surgery. The most common indications for surgery were cancer and inflammatory bowel diseases. Serum samples were obtained directly before surgery (D0) and 1 day (D1) after surgery, and the relationships between the serum concentrations of PCT and IL-6 and development of AL were assessed. RESULTS In total, 10.2% of patients developed post-surgical infections due to AL. PCT levels on D1 were significantly higher in patients who developed AL [2.73 (1.40-4.62)] than in those who recovered without complications [0.2 (0.09-0.44)]. The area under the ROC curve for PCT on D1 was 0.94, 95% CI (0.89-0.98). The sensitivity and specificity of the prediction of an infection were 87% and 87%, respectively, for PCT on D1, which was higher than 1.09 ng/mL. The increase in PCT concentration between D0 and D1 was significantly higher in patients with AL (p<0.001). Patients who developed AL had higher concentrations of IL-6 on D1, but the difference was not significant (p=0.28). CONCLUSIONS This study confirms that surgical trauma increases serum PCT concentrations and that the concentration of PCT on D1 can predict AL after colorectal surgery. However, IL-6 is not a good early marker for developing AL.
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Sharma D, Farahbakhsh N, Shastri S, Sharma P. Biomarkers for diagnosis of neonatal sepsis: a literature review. J Matern Fetal Neonatal Med 2017; 31:1646-1659. [PMID: 28427289 DOI: 10.1080/14767058.2017.1322060] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sepsis is an important cause of mortality and morbidity in neonatal populations. There has been constant search of an ideal sepsis biomarker that have high sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), so that both the diagnosis and exclusion of neonatal sepsis can be made at the earliest possible and appropriate antibiotics can be started to neonate. Ideal sepsis biomarker will help in guiding us when not to start antibiotics in case of suspect sepsis and total duration of antibiotics course in case of proven sepsis. There are numerous sepsis biomarkers that have been evaluated for early detection of neonatal sepsis but till date there is no single ideal biomarker that fulfills all essential criteria's for being an ideal biomarker. The most commonly used biomarkers are C-reactive protein (CRP) and procalcitonin (PCT), but both have shown varied sensitivity, specificity, PPV and NPV in different studies. We conducted literature search for various neonatal sepsis biomarkers and this review article will cover briefly all the markers with current available evidence.
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Affiliation(s)
- Deepak Sharma
- a Department of Neonatology , National Institute of Medical Sciences , Jaipur , Rajasthan , India
| | - Nazanin Farahbakhsh
- b Department of Pulmonology , Mofid Pediatrics Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sweta Shastri
- c Department of Pathology , N.K.P. Salve Medical College , Nagpur , Maharashtra , India
| | - Pradeep Sharma
- d Department of Medicine , Mahatma Gandhi Medical College , Jaipur , Rajasthan , India
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Hay DL, Walker CS. CGRP and its receptors. Headache 2017; 57:625-636. [PMID: 28233915 DOI: 10.1111/head.13064] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/26/2017] [Accepted: 02/01/2017] [Indexed: 02/01/2023]
Abstract
The calcitonin gene-related peptide (CGRP) neuropeptide system is an important but still evolving target for migraine. A fundamental consideration for all of the current drugs in clinical trials and for ongoing development in this area is the identity, expression pattern, and function of CGRP receptors because this knowledge informs safety and efficacy considerations. In recent years, only the calcitonin receptor-like receptor/receptor activity-modifying protein 1 (RAMP1) complex, known as the CGRP receptor, has generally been considered relevant. However, CGRP is capable of activating multiple receptors and could have more than one endogenous receptor. The recent identification of the CGRP-responsive calcitonin receptor/RAMP1 complex (AMY1 receptor - amylin subtype 1 receptor) in the trigeminovascular system warrants a deeper consideration of the molecular identity of CGRP receptor(s) involved in the pathophysiology, and thus potential treatment of migraine. This perspective considers some of the issues and implications.
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Affiliation(s)
- Debbie L Hay
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand
| | - Christopher S Walker
- School of Biological Sciences, The University of Auckland, Auckland, New Zealand
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Diagnostic Accuracy of Cerebrospinal Fluid Procalcitonin in Bacterial Meningitis Patients with Empiric Antibiotic Pretreatment. J Clin Microbiol 2017; 55:1193-1204. [PMID: 28179405 DOI: 10.1128/jcm.02018-16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/23/2017] [Indexed: 12/24/2022] Open
Abstract
Accurate diagnosis of bacterial meningitis (BM) relies on cerebrospinal fluid (CSF) Gram staining and bacterial culture, which often present high false-negative rates because of antibiotic abuse. Thus, a novel and reliable diagnostic biomarker is required. Procalcitonin (PCT) has been well demonstrated to be specifically produced from peripheral tissues by bacterial infection, which makes it a potential diagnostic biomarker candidate. Here, we performed a prospective clinical study comprising a total of 143 patients to investigate the diagnostic value of CSF PCT, serum PCT, and other conventional biomarkers for BM. Patients were assigned to the BM (n = 49), tuberculous meningitis (TBM) (n = 25), viral meningitis/encephalitis (VM/E) (n = 34), autoimmune encephalitis (AIE) (n = 15), or noninflammatory nervous system diseases (NINSD) group (n = 20). Empirical antibiotic pretreatment was not an exclusion criterion. Our results show that the CSF PCT level was significantly (P < 0.01) higher in patients with BM (median, 0.22 ng/ml; range, 0.13 to 0.54 ng/ml) than in those with TBM (median, 0.12 ng/ml; range, 0.07 to 0.16 ng/ml), VM/E (median, 0.09 ng/ml; range, 0.07 to 0.11 ng/ml), AIE (median, 0.06 ng/ml; range, 0.05 to 0.10 ng/ml), or NINSD (median, 0.07 ng/ml; range, 0.06 to 0.08 ng/ml). Among the assessed biomarkers, CSF PCT exhibited the largest area under the receiver operating characteristic curve (0.881; 95% confidence interval, 0.810 to 0.932; cutoff value, 0.15 ng/ml; sensitivity, 69.39%; specificity, 91.49%). Our study sheds light upon the diagnostic dilemma of BM due to antibiotic abuse. (This study has been registered at ClinicalTrials.gov under registration no. NCT02278016.).
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Hu Y, Yang M, Zhou Y, Ding Y, Xiang Z, Yu L. Establishment of reference intervals for procalcitonin in healthy pregnant women of Chinese population. Clin Biochem 2017; 50:150-154. [DOI: 10.1016/j.clinbiochem.2016.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/04/2016] [Accepted: 10/18/2016] [Indexed: 11/16/2022]
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Bañuelos-Andrío L, Espino-Hernández M, Ruperez-Lucas M, Villar-del Campo M, Romero-Carrasco C, Rodríguez-Caravaca G. Usefulness of analytical parameters in the management of pediatric patients with suspicion of acute pyelonephritis. Is procalcitonin reliable? Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2016.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Barton AK, Pelli A, Rieger M, Gehlen H. Procalcitonin as a biomarker in equine chronic pneumopathies. BMC Vet Res 2016; 12:281. [PMID: 27938364 PMCID: PMC5148850 DOI: 10.1186/s12917-016-0912-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 12/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Procalcitonin (PCT), a precursor protein of the hormone calcitonin, is a sensitive inflammatory marker in human medicine, which is primarily used for diagnosis of bacterial sepsis, but is also useful in diagnosis of exacerbation of asthma and COPD. In this study, PCT was evaluated as a potential biomarker for different chronic pneumopathies in the horse using an equine specific ELISA in comparison to established clinical markers and different interleukins. Sixty-four horses were classified as free of respiratory disease, recurrent airway obstruction (RAO), inflammatory airway disease (IAD) or chronic interstitial pneumopathy (CIP) using a scoring system. PCT concentrations were measured in plasma (n = 17) and in the cell-free supernatant of bronchoalveolar lavage (n = 64). PCT concentrations were correlated to interleukins IL-1ß and IL-6 in BALF, clinical findings and BALF cytology. RESULTS The median PCT concentrations in plasma were increased in respiratory disease (174.46 ng/ml, n = 7) compared to controls (13.94 ng/ml, n = 10, P = 0.05) and correlated to PCT in BALF supernatant (rs = 0.48). Compared to controls (5.49 ng/ml, n = 15), median PCT concentrations in BALF supernatant correlated to the overall clinical score (rs = 0.32, P = 0.007) and were significantly increased in RAO (13.40 ng/ml, n = 21) and IAD (16.89 ng/ml, n = 16), while no differences were found for CIP (12.02 ng/ml, n = 12). No significant increases were found for IL-1 and IL-6 between controls and respiratory disease in general as well as different disease groups. CONCLUSIONS Although some correlations were found between PCT in plasma, BALF supernatant and clinical scores, PCT in BALF does not seem to be a superior marker compared to established clinical markers. PCT in plasma seems to be more promising and a greater number of samples should be evaluated in further studies.
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Affiliation(s)
- Ann Kristin Barton
- Equine Clinic, Freie Universitaet Berlin, Oertzenweg 19b, 10163 Berlin, Germany
| | - Anna Pelli
- Equine Clinic, Freie Universitaet Berlin, Oertzenweg 19b, 10163 Berlin, Germany
| | - Martin Rieger
- Research unit microbe-plant interactions, Helmholtz Zentrum Muenchen, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Heidrun Gehlen
- Equine Clinic, Freie Universitaet Berlin, Oertzenweg 19b, 10163 Berlin, Germany
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Noh SH, Park SD, Kim EJ. Serum Procalcitonin Level Reflects the Severity of Cellulitis. Ann Dermatol 2016; 28:704-710. [PMID: 27904269 PMCID: PMC5125951 DOI: 10.5021/ad.2016.28.6.704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 03/21/2016] [Accepted: 03/30/2016] [Indexed: 12/03/2022] Open
Abstract
Background Cellulitis is a common bacterial infection of the superficial skin. Procalcitonin is one of the precursor proteins of calcitonin, its levels are elevated in bacterial infection, and it has been established as a diagnostic marker for severe bacterial infections. Objective This study evaluated the clinical usefulness of procalcitonin for predicting disease severity and prognosis of cellulitis. Methods We reviewed the medical records of 160 patients diagnosed with cellulitis in the past 3 years. Body temperature, procalcitonin, white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were measured on their first day of admission. The associations of procalcitonin, WBC, ESR, and CRP with the body temperature and the number of hospitalized days were assessed. Results Procalcitonin, WBC, and CRP showed a positive correlation with body temperature. In addition, procalcitonin, WBC, ESR, and CRP showed a positive correlation with number of hospitalized days (p<0.05). Conclusion In patients diagnosed with cellulitis, proclacitonin was a helpful parameter to indicate the severity of disease and also a useful predictor of prognosis.
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Affiliation(s)
- Soo Hyeon Noh
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Seok Don Park
- Department of Dermatology, Gunsan Medical Center, Gunsan, Korea
| | - Eun Jung Kim
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
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Bañuelos-Andrío L, Espino-Hernández M, Ruperez-Lucas M, Villar-Del Campo MC, Romero-Carrasco CI, Rodríguez-Caravaca G. Usefulness of analytical parameters in the management of paediatric patients with suspicion of acute pyelonephritis. Is procalcitonin reliable? Rev Esp Med Nucl Imagen Mol 2016; 36:2-6. [PMID: 27329559 DOI: 10.1016/j.remn.2016.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 04/12/2016] [Accepted: 05/06/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the usefulness of procalcitonin (PCT) and other analytical parameters (white blood cell count [WBC], C-reactive protein [CRP]) as markers of acute renal damage in children after a first febrile or afebrile urinary tract infection (UTI). METHODS A retrospective study was conducted on children with a first episode of UTI admitted between January 2009 to December 2011, and in whom serum PCT, CRP and white blood cell count were measured, as well as assessing the acute renal damage with renal scintigraphy with 99mTc-DMSA (DMSA) within the first 72h after referral. A descriptive study was performed and ROC curves were plotted, with optimal cut-off points calculated for each parameter. RESULTS The 101 enrolled patients were divided into two groups according to DMSA scintigraphy results, with 64 patients being classified with acute pyelonephritis (APN), and 37 with UTI. The mean WBC, CRP and PCT values were significantly higher in patients with APN with respect to normal acute DMSA. The area under the ROC curve was 0.862 for PCR, 0.774 for WBC, and 0.731 for PCT. The optimum statistical cut-off value for PCT was 0.285ng/ml (sensitivity 71.4% and specificity 75%). CONCLUSION Although the mean levels of fever, WBC, CRP, and PCT were significantly increased in patients with APN than in those who had UTI, the sensitivity and specificity of these analytical parameters are unable to predict the existence of acute renal damage, making the contribution by renal DMSA scintigraphy essential.
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Affiliation(s)
- L Bañuelos-Andrío
- Unidad de Medicina Nuclear, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | | | - M Ruperez-Lucas
- Servicio de Pediatría, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | | | - C I Romero-Carrasco
- Unidad de Medicina Nuclear, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - G Rodríguez-Caravaca
- Servicio de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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Fontela PS, Lacroix J. Procalcitonin: Is This the Promised Biomarker for Critically Ill Patients? J Pediatr Intensive Care 2016; 5:162-171. [PMID: 31110901 DOI: 10.1055/s-0036-1583279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/19/2015] [Indexed: 12/23/2022] Open
Abstract
Objective Procalcitonin (PCT) has been increasingly used in the critical care setting to determine the presence of bacterial infection and also to guide antibiotic therapy. We reviewed PCT's physiologic role, as well as its clinical utility for the management of pediatric critically ill patients. Findings PCT is a precursor of the hormone calcitonin. Its production is induced by inflammatory conditions, especially bacterial infections. Literature shows that PCT is a moderately reliable diagnostic test for severe bacterial infection in children. Synthesis of available adult studies suggests that the use of PCT-based algorithms to support medical decision making reduces antibiotic exposure without compromising safety in critically ill patients. However, no study has addressed the usefulness and safety of PCT to guide antibiotic therapy in severely ill children. In pediatric patients with acute lower respiratory tract infections, the use of PCT-based algorithms also led to a safe decrease in antibiotic treatment duration. Conclusion PCT has demonstrated clinical utility in the pediatric critical care setting when used for the diagnosis of bacterial infections and to guide antibiotic use in children with acute lower respiratory tract infections. However, more research is needed in critically ill children to determine the utility of PCT-driven antibiotic therapy in this population.
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Affiliation(s)
- Patricia S Fontela
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Jacques Lacroix
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
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Barton AK, Rieger M, Teschner D, Gehlen H. Procalcitonin—A Useful Biomarker for Pneumonia Associated with <i>Rhodococcus equi</i>? ACTA ACUST UNITED AC 2016. [DOI: 10.4236/mri.2016.52002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shen WJ, Zhuo Y, Chai YQ, Yang ZH, Han J, Yuan R. Enzyme-free electrochemical immunosensor based on host-guest nanonets catalyzing amplification for procalcitonin detection. ACS APPLIED MATERIALS & INTERFACES 2015; 7:4127-4134. [PMID: 25629216 DOI: 10.1021/am508137t] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
An enzyme-free electrochemical immunosensor based on the host-guest nanonets of N,N-bis(ferrocenoyl)-diaminoethane/β-cyclodextrins/poly(amidoamine) dendrimer-encapsulated Au nanoparticles (Fc-Fc/β-CD/PAMAM-Au) for procalcitonin (PCT) detection has been developed in this study. The signal probe was constructed as follows: amine-terminated β-CD was adsorbed to PAMAM-Au first, and then the prepared Fc-Fc was recognized by the β-CD to form stable host-guest nanonets. Next, secondary antibodies (Ab2) were attached into the formed netlike nanostructure of Fc-Fc/β-CD/PAMAM-Au by chemical absorption between PAMAM-Au and -NH2 of β-CD. Herein, the PAMAM-Au act not only as nanocarriers for anchoring large amounts of the β-CD and Ab2 but also as nanocatalysts to catalyze the oxidation of ascorbic acid (AA) for signal amplification. Moreover, the Fc-Fc could be stably immobilized by the hydrophobic inner cavity of β-CD as well as improving solubility by the hydrophilic exterior of β-CD. With the unique structure of two ferrocene units, Fc-Fc not only affords more electroactive groups to make the electrochemical response more sensitive but also plays a role of combining dispersive β-CD-functionalized PAMAM-Au to form the netlike nanostructure. Furthermore, Fc-Fc exhibits good catalytic activity for AA oxidation. When the detection solution contained AA, the synergetic catalysis of PAMAM-Au and Fc-Fc to AA oxidation could be obtained, realizing enzyme-free signal amplification. The proposed immunosensor provided a linear range from 1.80 pg/mL to 500 ng/mL for PCT detection and a detection limit of 0.36 pg/mL under optimal experimental conditions. Moreover, the immunosensor has shown potential application in clinical detection of PCT.
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Affiliation(s)
- Wen-Jun Shen
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry, Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University , Chongqing 400715, People's Republic of China
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Cai ZH, Fan CL, Zheng JF, Zhang X, Zhao WM, Li B, Li L, Dong PL, Ding HG. Measurement of serum procalcitonin levels for the early diagnosis of spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis. BMC Infect Dis 2015; 15:55. [PMID: 25887691 PMCID: PMC4332920 DOI: 10.1186/s12879-015-0776-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 01/21/2015] [Indexed: 12/12/2022] Open
Abstract
Background It is difficult to diagnose spontaneous bacterial peritonitis (SBP) early in decompensated liver cirrhotic ascites patients (DCPs). The aim of the study was to measure serum procalcitonin (PCT) levels and peripheral blood leukocyte/platelet (WBC/PLT) ratios to obtain an early diagnostic indication of SBP in DCPs. Methods Our cohort of 129 patients included 112 DCPs (94 of whom had infections) and 17 cases with compensated cirrhosis as controls. Bacterial cultures, ascitic fluid (AF) leukocyte and peripheral WBC/PLT counts, and serum PCT measurements at admission were carried out prior to the use of antibiotics. Receiver operating characteristic (ROC) curves were generated to test the accuracies and cut-off values for different inflammatory markers. Results Among the 94 infected patients, 66 tested positive by bacterial culture, for which the positivity of blood, ascites and other secretions were 25.8%, 30.3% and 43.9%, respectively. Lung infection, SBP and unknown sites of infection accounted for 8.5%, 64.9% and 26.6% of the cases, respectively. Serum PCT levels (3.02 ± 3.30 ng/mL) in DCPs with infections were significantly higher than those in control patients (0.15 ± 0.08 ng/mL); p < 0.05. We used PCT ≥0.5 ng/mL as a cut-off value to diagnose infections, for which the sensitivity and specificity was 92.5% and 77.1%. The area under the curve (AUC) was 0.89 (95% confidence interval: 0.84–0.91). The sensitivity and specificity were 62.8% and 94.2% for the diagnosis of infections, and were 68.8% and 94.2% for the diagnosis of SBP in DCPs when PCT ≥2 ng/mL was used as a cut-off value. For the combined PCT and WBC/PLT measurements, the sensitivity was 76.8% and 83.6% for the diagnosis of infections or SBP in DCPs, respectively. Conclusion Serum PCT levels alone or in combination with WBC/PLT measurements seem to provide a satisfactory early diagnostic biomarker in DCPs with infections, especially for patients with SBP.
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Affiliation(s)
- Zhao-Hua Cai
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China. .,Department of Internal Medicine, The Second Hospital Beijing, Beijing, Xicheng District, 100031, China.
| | - Chun-Lei Fan
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Jun-Fu Zheng
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Xin Zhang
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Wen-Min Zhao
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Bing Li
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Lei Li
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Pei-Ling Dong
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
| | - Hui-Guo Ding
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital affiliated to Capital Medical University, Beijing, Fengtai District, 100069, China.
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Tavares E, Maldonado R, Miñano FJ. Immunoneutralization of Endogenous Aminoprocalcitonin Attenuates Sepsis-Induced Acute Lung Injury and Mortality in Rats. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:3069-83. [DOI: 10.1016/j.ajpath.2014.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 05/28/2014] [Accepted: 07/07/2014] [Indexed: 12/22/2022]
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41
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Shaikh MM, Hermans LE, van Laar JM. Is serum procalcitonin measurement a useful addition to a rheumatologist's repertoire? A review of its diagnostic role in systemic inflammatory diseases and joint infections. Rheumatology (Oxford) 2014; 54:231-40. [DOI: 10.1093/rheumatology/keu416] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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42
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Evaluation of serum procalcitonin and C-reactive protein levels as biomarkers of Henoch-Schönlein purpura in pediatric patients. Clin Rheumatol 2014; 35:667-71. [DOI: 10.1007/s10067-014-2773-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 11/29/2022]
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43
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Procalcitonin sensitive detection based on graphene–gold nanocomposite film sensor platform and single-walled carbon nanohorns/hollow Pt chains complex as signal tags. Biosens Bioelectron 2014; 60:210-7. [DOI: 10.1016/j.bios.2014.03.071] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/30/2014] [Accepted: 03/31/2014] [Indexed: 02/01/2023]
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44
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Total internal reflection (TIRF)-based quantification of procalcitonin for sepsis diagnosis – A point-of-care testing application. Biosens Bioelectron 2014; 59:251-8. [DOI: 10.1016/j.bios.2014.03.052] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/27/2014] [Accepted: 03/20/2014] [Indexed: 02/02/2023]
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45
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Liu X, Wang DF, Fang Y, Ye WF, Liu S, Lou N. Initial procalcitonin level predicts infection and its outcome in patients with non-Hodgkin lymphoma with febrile neutropenia. Leuk Lymphoma 2014; 56:85-91. [PMID: 24707944 DOI: 10.3109/10428194.2014.911864] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We explored whether initially determined procalcitonin (PCT) levels could facilitate assessment of the risks of infection and death due to treatment failure in patients with non-Hodgkin lymphoma (NHL) with newly developed febrile neutropenia (FN). In the 212 examined episodes, the initial PCT value was markedly higher in patients with microbiologically documented infection (MDI) or clinically documented infection compared with patients with fevers of unknown origin (p < 0.001 for both). Patients with initial PCT values ≥ 0.50 ng/mL were at high risk of MDI (sensitivity 83.5%, specificity 77.2%). A significantly elevated PCT level was closely correlated with patient mortality (area under the curve [AUC] 0.864, 95% confidence interval [CI] 0.811-0.907, p < 0.001) and patients' admission to the intensive care unit (AUC 0.926, 95% CI 0.882-0.957, p < 0.001). In conclusion, the initially determined PCT value was a useful marker for identifying infection and predicting outcome in patients with NHL with FN.
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Affiliation(s)
- Xiao Liu
- Department of Critical Care Medicine, Sun Yat-sen University Cancer Center and State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
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46
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Floras ANK, Holowaychuk MK, Hodgins DC, Marr HS, Birkenheuer A, Sharif S, Bersenas AME, Bienzle D. Investigation of a commercial ELISA for the detection of canine procalcitonin. J Vet Intern Med 2014; 28:599-602. [PMID: 24495235 PMCID: PMC4857980 DOI: 10.1111/jvim.12309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 10/01/2013] [Accepted: 12/16/2013] [Indexed: 12/29/2022] Open
Abstract
Background Rapid identification of sepsis enables prompt administration of antibiotics and is essential to improve patient survival. Procalcitonin (PCT) is a biomarker used to diagnose sepsis in people. Commercial assays to measure canine PCT peptide have not been validated. Objective To investigate the validity of a commercially available enzyme‐linked immunosorbent assay (ELISA) marketed for the measurement of canine PCT. Animals Three dogs with sepsis, 1 healthy dog, 1 dog with thyroid carcinoma. Methods Experimental study. The ELISA's ability to detect recombinant and native canine PCT was investigated and intra‐assay and interassay coefficients of variability were calculated. Assay validation including mass spectrometry of the kit standard solution was performed. Results The ELISA did not consistently detect recombinant canine PCT. Thyroid lysate yielded a positive ELISA signal. Intra‐assay variability ranged from 18.9 to 77.4%, while interassay variability ranged from 56.1 to 79.5%. Mass spectrometry of the standard solution provided with the evaluated ELISA kit did not indicate presence of PCT. Conclusions and Clinical Importance The results of this investigation do not support the use of this ELISA for the detection of PCT in dogs.
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Affiliation(s)
- A N K Floras
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Liu F, Xiang G, Chen X, Luo F, Jiang D, Huang S, Li Y, Pu X. A novel strategy of procalcitonin detection based on multi-nanomaterials of single-walled carbon nanohorns–hollow Pt nanospheres/PAMAM as signal tags. RSC Adv 2014. [DOI: 10.1039/c4ra00169a] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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48
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Tavares E, Maldonado R, Miñano FJ. Aminoprocalcitonin-mediated suppression of feeding involves the hypothalamic melanocortin system. Am J Physiol Endocrinol Metab 2013; 304:E1251-62. [PMID: 23571710 DOI: 10.1152/ajpendo.00590.2012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aminoprocalcitonin (N-PCT), a neuroendocrine peptide encoded by the calcitonin-I (CALC-I) gene, suppresses food intake when administered centrally in rats. However, the neural pathways underlying this effect remain unclear. N-PCT and calcitonin receptors (CT-R) have been identified in hypothalamic regions involved in energy homeostasis, including the arcuate nucleus (ARC). Here, we hypothesized an involvement of the hypothalamic ARC in mediating the anorexic effects of central N-PCT based on its content of peptidergic neurons involved in feeding and its expression of N-PCT and CT-R. Fasting strongly reduced expression of the N-PCT precursor gene CALC-I in the ARC, and central immunoneutralization of endogenous N-PCT increased food intake. Intracerebroventricular administration of N-PCT reduced food intake in fed and fasted rats, and its effect was attenuated by a neutralizing anti-N-PCT antibody. Immunohistochemistry for N-PCT showed that it is expressed in astrocytes and neurons in the ARC and is colocalized with anorexigenic proopiomelanocortin (POMC) neurons. Fasting reduced coexpression of N-PCT and POMC, and N-PCT administration activated hypothalamic neurons, including rostral POMC neurons. We also found that N-PCT stimulates POMC mRNA expression in fed and fasted rats, whereas it reduced the expression of orexigenic peptides neuropeptide Y (NPY) and agouti-related peptide (AgRP) only in fasted rats in which those mRNAs are normally elevated. Finally, we showed that the melanocortin-3/4 receptor antagonist SHU 9119 attenuates the intake-suppressive effect of N-PCT. These data demonstrate that hypothalamic N-PCT is involved in control of energy balance and that its anorexigenic effects are mediated through the melanocortin system.
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MESH Headings
- Agouti-Related Protein/genetics
- Agouti-Related Protein/metabolism
- Animals
- Anorexia/metabolism
- Anorexia/physiopathology
- Antibodies, Neutralizing/pharmacology
- Arcuate Nucleus of Hypothalamus/physiology
- Calcitonin/genetics
- Calcitonin/immunology
- Calcitonin/metabolism
- Calcitonin Gene-Related Peptide
- Eating/physiology
- Energy Metabolism/physiology
- Feeding Behavior/physiology
- Male
- Melanocyte-Stimulating Hormones/pharmacology
- Neuropeptide Y/genetics
- Neuropeptide Y/metabolism
- Protein Precursors/genetics
- Protein Precursors/immunology
- Protein Precursors/metabolism
- Rats
- Rats, Wistar
- Receptor, Melanocortin, Type 3
- Receptor, Melanocortin, Type 4/antagonists & inhibitors
- Receptor, Melanocortin, Type 4/metabolism
- Receptors, Melanocortin/antagonists & inhibitors
- Receptors, Melanocortin/metabolism
- Signal Transduction/physiology
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Affiliation(s)
- Eva Tavares
- Unidad de Farmacología Experimental y Clínica, Hospital Universitario de Valme, Seville, Spain; and
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Long H, Yang H, Lin Y, Situ D, Liu W. Fish Oil-Supplemented Parenteral Nutrition in Patients Following Esophageal Cancer Surgery: Effect on Inflammation and Immune Function. Nutr Cancer 2013; 65:71-5. [DOI: 10.1080/01635581.2013.741761] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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50
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McCann FJ, Chapman SJ, Yu WC, Maskell NA, Davies RJO, Lee YCG. Ability of procalcitonin to discriminate infection from non-infective inflammation using two pleural disease settings. PLoS One 2012; 7:e49894. [PMID: 23251353 PMCID: PMC3520973 DOI: 10.1371/journal.pone.0049894] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 10/15/2012] [Indexed: 01/09/2023] Open
Abstract
UNLABELLED Procalcitonin has been shown to be useful in separating infection from non-infective disorders. However, infection is often paralleled by tissue inflammation. Most studies supporting the use of procalcitonin were confounded by more significant inflammation in the infection group. Few studies have examined the usefulness of procalcitonin when adjusted for inflammation.Pleural inflammation underlies the development of most exudative effusions including pleural infection and malignancy. Pleurodesis, often used to treat effusions, involves provocation of intense aseptic pleural inflammation. We conducted a two-part proof-of-concept study to test the specificity of procalcitonin in differentiating infection using cohorts of patients with pleural effusions of infective and non-infective etiologies, as well as subjects undergoing pleurodesis. METHODS We measured the blood procalcitonin level (i) in 248 patients with pleural infection or with non-infective pleural inflammation, matched for severity of systemic inflammation by C-reactive protein (CRP), age and gender; and (ii) in patients before and 24-48 hours after induction of non-infective pleural inflammation (from talc pleurodesis). RESULTS 1) Procalcitonin was significantly higher in patients with pleural infection compared with controls with non-infective effusions (n = 32 each group) that were case-matched for systemic inflammation as measured by CRP [median (25-75%IQR): 0.58 (0.35-1.50) vs 0.34 (0.31-0.42) µg/L respectively, p = 0.003]. 2) Talc pleurodesis provoked intense systemic inflammation, and raised serum CRP by 360% over baseline. However procalcitonin remained relatively unaffected (21% rise). 3) Procalcitonin and CRP levels did not correlate. In 214 patients with pleural infection, procalcitonin levels did not predict the survival or need for surgical intervention. CONCLUSION Using a pleural model, this proof-of-principle study confirmed that procalcitonin is a biomarker specific for infection and is not affected by non-infective inflammation. Procalcitonin is superior to CRP in distinguishing infection from non-infective pleural diseases, even when controlled for the level of systemic inflammation.
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Affiliation(s)
- Fiona J. McCann
- Oxford Centre for Respiratory Medicine and University of Oxford, Oxford, United Kingdom
| | - Stephen J. Chapman
- Oxford Centre for Respiratory Medicine and University of Oxford, Oxford, United Kingdom
| | - Wai Cho Yu
- Department of Medicine, Princess Margaret Hospital, Hong Kong, Special Administrative Region, People's Republic of China
| | - Nick A. Maskell
- North Bristol Lung Centre, Southmead Hospital, Bristol, United Kingdom
| | - Robert J. O. Davies
- Oxford Centre for Respiratory Medicine and University of Oxford, Oxford, United Kingdom
| | - Y. C. Gary Lee
- Oxford Centre for Respiratory Medicine and University of Oxford, Oxford, United Kingdom
- Centre for Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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