title: Presepsin is an early monitoring biomarker for predicting clinical outcome in patients with sepsis.
abstract: Despite their undoubted helpfulness in diagnosing sepsis, increased blood C-reactive protein (CRP) and procalcitonin (PCT) levels have been described in many noninfectious conditions. Presepsin is a soluble fragment of the cluster of differentiation 14 involved in pathogen recognition by innate immunity. We aimed to investigate the diagnostic and prognostic performance of presepsin in comparison to PCT and CRP in patients presenting with systemic inflammatory response syndrome (SIRS) and suspected sepsis. Seventy-six subjects were enrolled in this study, including 51 patients with SIRS as well as 25 healthy subjects. Plasma presepsin, PCT and CRP levels were serially measured on admission and at days 1, 3, 7 and 15. Presepsin and PCT yielded similar diagnostic accuracy, whereas presepsin performed significantly better than CRP. Presepsin and PCT showed comparable performance for predicting 28-day mortality, and both biomarkers performed significantly better than CRP. In septic patients, presepsin revealed earlier concentration changes over time when compared to PCT and CRP. Presepsin and PCT could differentiate between septic and non-septic patients with comparable accuracy and both biomarkers showed similar performance for predicting 28-day mortality. Early changes in presepsin concentrations might reflect the appropriateness of the therapeutic modality and could be useful for making effective treatment decisions.
authors.affiliation: Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt.
authors.forename: Fahmy T
authors.initials: FT
authors.lastname: Ali
authors.affiliation: Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt. Electronic address: mohd_ali2@sci.asu.edu.eg.
authors.forename: Mohamed A M
authors.initials: MA
authors.lastname: Ali
authors.affiliation: Microbiology and Immunology Department, El-Maadi Military Hospital, Cairo, Egypt.
authors.forename: Mostafa M
authors.initials: MM
authors.lastname: Elnakeeb
authors.affiliation: Microbiology and Immunology Department, El-Maadi Military Hospital, Cairo, Egypt.
authors.forename: Heba N M
authors.initials: HN
authors.lastname: Bendary
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis; D013997:Time Factors
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; C000594167:presepsin protein, human; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: C-reactive protein; Presepsin; Procalcitonin; Sepsis; Systemic inflammatory response syndrome