The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients

Changes of C-reactive protein and Procalcitonin after four weeks of treatment in patients with pulmonary TB

Objective

Tuberculosis (TB) remains a public health concern worldwide, affecting millions of people every year. Detailed characterization of disease pathophysiology is key to proper diagnosis, disease progression, or treatment follow-up and evaluation. The present study investigated C-reactive protein and Procalcitonin (PCT) as candidate markers of early treatment response and disease activity.

Methods

From September to December 2019, 21 HIV-negative consecutive TB patients were recruited, within the setting of the Gabonese TB specialized hospital and the National Laboratory of Public Health, in a prospective study. CRP and PCT levels were measured by chemiluminescence at diagnosis and 4 weeks following the initiation of anti-TB treatment.

Results

The mean concentration of CRP in TB patients was 114.7 mg/L (95 % CI: [83.8-145.6]) at diagnosis and 20.2 mg/L (95 % CI: [14.1-26.4]) 4 weeks following anti-TB treatment. The drop in CRP concentrations between diagnosis, and week 4 following anti-TB treatment showed was significant (p < 0.0001). The average concentration of PCT at the time of diagnosis was 0.3 ng/mL (95 % CI: [0.19-0.41]). PCT Concentration dropped below 0.05 ng/mL 4 weeks following the start of anti-TB treatment (p < 0.01).

Conclusion

CRP and PCT are potential TB biomarkers, each, carrying important keys. If the drop in both proteins may indicate a significant reduction of the Mtb burden, the maintenance of CRP above the inflammation threshold could indicate the presence of residual bacilli. However, the clinical translation of the present finding will require more investigation.

MCP1, CRP and Procalcitonin as Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Background & Aims:

The aim of the study was to evaluate serum c-reactive protein (CRP), ascitic procalcitonin (PCT) and monocyte chemotactic protein-1 (MCP-1) in the diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients.

Methods:

A cross-sectional analytic study that included 199 patients with decompensated cirrhosis (101 with SBP and 98 without SBP). Patients were classified according to Child-Pugh criteria. Ascitic PCT and MCP-1 were measured by enzyme-linked immunosorbent assay. Serum CRP, liver and renal functions were assessed.

Results:

Three markers are significantly elevated in SBP patients than those without ascites. Using the ROC curve at AUC 0.883 and a cut-off value of >186 ng/ml, the diagnostic performance of ascitic MCP-1 level was higher than CRP (AUC 0.562) and ascitic fluid procalcitonin (AUC 0.751) in the diagnosis of SBP. The sensitivity and specificity were 86.15% and 79.59% at the cutoff of 186 ng/ml for MCP-1, 65.4 and 75.5 at ≥ 1 ng/ml for PCT, and 52.5 and 64.3, respectively for at 11.2 mg/dl CRP.

Conclusion:

Ascitic MCP-1 has a better diagnostic value with higher sensitivity and specificity in diagnosis SBP compared to CRP and procalcitonin which has higher diagnostic accuracy than CRP. Further studies with a large number will be necessary to evaluate the usefulness of these markers in diagnosis, follow-up and relation to morbidity and mortality of SBP patients.

D, Hassan AS, Zahran FE, Abdelghany RS, Siddik RI, Abdel-Hamed AR. The Role of MicroRNAs (miRNA 155, miRNA-146b) and Procalcitonin as Novel Markers for the Diagnosis of Spontaneous Bacterial Peritonitis

Background:

MircoRNAs are endogenous, small non-coding RNA molecules that have been recognized as important modulators of gene expression. MicroRNA is considered one of the potential biomarkers of infection and inflammation. Our study aims to identify the potential role of miRNA-155, miRNA-146b, and Procalcitonin (PCT) in the early detection of spontaneous bacterial peritonitis in cirrhotic liver patients. miRNA-155 and 146b are molecular biomarkers , while procalcitonin is a serum marker in ascites patients complicated with Spontaneous Bacterial Peritonitis (SBP) .

Methods:

This study was conducted on 199 patients, 101 of them have ascites complicated with spontaneous bacterial peritonitis, and 98 patients without spontaneous bacterial peritonitis (control group). Ascitic fluid samples were collected from patients with SBP undergoing paracentesis at National Hepatology Institute in Egypt. MicroRNAs were determined in the serum using qPCR (quantitative polymerase chain reaction), while procalcitonin has been assessed in serum samples using ELISA (Enzyme-linked immune assay) technique.

Results:

Serum levels of miRNA-146b & miRNA-155 were significantly higher (p<0.001) in spontaneous bacterial peritonitis patients (79.2% and 97.0% respectively) than ascites patients (17.3% and 7.1%, respectively). Furthermore, the serum level of procalcitonin was significantly higher (p<0.001) in spontaneous bacterial peritonitis patients than that in ascites patients (68.3% and 27.6%, respectively).

Conclusion:

miRNA-155, miRNA-146b and procalcitonin can be used as early markers for the detection of SBP in hepatic patients with ascites.