There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Introduction
CD14 is present in macrophage, monocyte, and granulocyte cells and their cell membranes,
and its soluble fraction is present in blood and is thought to be produced in association
with infections. It is called the soluble CD14 subtype, and its generic name is presepsin.
Presepsin is a novel marker for the diagnosis of sepsis, and the results of previous
study in which an ELISA kit was used showed a specific increase in sepsis in the early
stage that also correlated well with severity. In the present study we developed a
new rapid measurement method for whole blood that use a chemiluminescence enzyme immunoassay.
We assessed the usefulness of presepsin values in sepsis.
Methods
The period of the study was the 10 months from August 2009 to June 2010. The subjects
were 41 in-patients, age 62 ± 19 years old, who had been brought to the Critical Care
and Emergency Center of Iwate Medical University and who fulfilled at least two of
the diagnostic criteria for systemic inflammatory response syndrome (SIRS) on arrival.
Blood specimens were collected a total of six times; that is, on admission, and 12
and 24 hours and 3, 5, and 7 days later. Presepsin values were measured by immunoassay
analyzer (PATHFAST; Mitsubishi Chemical Medience Corporation, Japan). The sepsis marker
PCT, IL-6, and CRP were also measured for comparison. In addition, 128 healthy subjects
were assessed as controls.
Results
The mean presepsin level in the 128 healthy subjects in the control group was 190
pg/ml. The corresponding presepsin levels were normal (non-infection), 294.2 ± 121.4
pg/ml; local infection, 721.0 ± 611.3 pg/ml; SIRS, 333.5 ± 130.6 pg/ml; sepsis, 817.9
± 572.7 pg/ml; and severe sepsis, 1,992.9 ± 1,509.2 pg/ml; the patients with local
infection or sepsis had significantly higher presepsin levels than the patients who
did not have infection as a complication. In addition, the presepsin levels in SIRS
that was not complicated by infection were significantly lower than in sepsis. When
we divided the patients into an infection group and a no infection group and plotted
the ROC curves of each of the markers to compare presepsin with other markers, the
results showed that presepsin was the best.
Conclusion
We were able to obtain results similar to those obtained with the conventional ELISA
method, and it was possible to diagnose sepsis more rapidly and conveniently using
the immunoassay analyzer.
This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (
http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.