Copeptin: a new and promising diagnostic and prognostic marker.
The study conducted by Seligman and coworkers included in the previous issue of Critical Care demonstrates that copeptin is a promising marker to predict outcome in patients with ventilator-associated pneumonia. In recent years, copeptin has emerged as a new prognostic marker in a variety of diseases, such as sepsis, community-acquired pneumonia, chronic obstructive pulmonary failure, heart failure and myocardial infarction. What is the pathophysiological basis for these findings? Copeptin together with vasopressin is co-secreted from the posterior pituitary and therefore mirrors the amount of vasopressin in the circulation. Vasopressin is a main secretagogue of the hypothalamo-pituitary-adrenal axis, thereby mirroring the individual stress level. Furthermore, vasopressin is an important hormone in salt and volume regulation. In this context, copeptin is also a diagnostic marker in patients with diabetes insipidus and in patients with disordered water states.
Katan
Mira
M
Department of Endocrinology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Müller
Beat
B
Christ-Crain
Mirjam
M
D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins