Determining the factors affecting serum presepsin level and its diagnostic utility: A cross-sectional study

Tsuchida, Tomoya; Ie, Kenya; Okuse, Chiaki; Hirose, Masahiro; Nishisako, Hisashi; Torikai, Keito; Tanaka, Taku; Kunishima, Hiroyuki; Matsuda, Takahide

doi:10.1016/j.jiac.2020.11.013

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…First, this study was carried out at a single center and had a limited sample size; these factors could potentially restrict the generalizability of our findings. Second, we did not take renal function into account when establishing the reference values for presepsin and PCT; previous research has indicated that renal function can impact the levels of presepsin [28,29]. Ideally, future reference values should be set based on an assessment of renal function.…”

Section: Discussionmentioning

confidence: 99%

Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions

2024

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The objective of this study was to investigate whether presepsin can serve as a useful biomarker for predicting septic shock and mortality rates in patients with urinary tract infections (UTI) as defined by the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). This single-center and prospective observational study was carried out between December 2019 and December 2022 and included 171 UTI patients divided into two groups: a non-septic shock group (n = 121) and a septic shock group (n = 50). The primary outcome of this study was the development of septic shock; the secondary outcome was 30-day hospital mortality. Receiver operating characteristic (ROC) curves and multivariate regression analyses were performed to investigate the predictive value of presepsin levels for septic shock and the Cox proportional hazards model was used to determine the risk factors for 30-day hospital mortality in UTI patients. Septic shock patients had significantly higher serum levels of presepsin when compared to the non-septic shock group (p < 0.001). In multivariate logistic regression analysis, presepsin demonstrated its independent role as a risk factor for septic shock (odds ratio (OR): 1.002; 95% confidence interval (CI): 1.001–1.002; p < 0.001). The multivariate Cox proportional hazards model indicated that presepsin represents a significant predictor of 30-day hospital mortality in septic shock patients (hazard ratio (HR): 1.0005; 95% CI: 1.0001–1.001; p < 0.05). The ROC curve for diagnosing septic shock had an area under the curve (AUC) of 0.739 with a cutoff value of 447 pg/mL for presepsin. For the prediction of 30-day hospital mortality in patients with UTI, an optimal presepsin cutoff of 709 pg/mL was determined; ROC curve analysis yielded an AUC of 0.744. When applying the Sepsis-3 criteria, presepsin levels represented a significant independent risk factor for septic shock and 30-day hospital mortality in UTI patients.

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Section: Discussionmentioning

confidence: 99%

Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions

2024

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“…One of the potential biomarkers is procalcitonin, a calcitonin precursor produced by the thyroid gland, which has been shown to predict the severity of AC, sepsis, and the need for antibiotics and urgent biliary drainage [ 49 – 53 ]. Other blood biomarkers that have been reported to predict the severity of AC include presepsin, a fragment of the CD14 receptor complex; lactate, a metabolic product of host cells and bacteria; and lipocalin 2, a transporter of small and hydrophobic molecules [ 54 – 56 ]. In this study, we found that the plasma level of corisin, a novel peptide of bacterial origin, was significantly elevated in patients with AC, particularly those with severe disease, compared to non-severe and non-AC patients.…”

Section: Discussionmentioning

confidence: 99%

Elevated plasma and bile levels of corisin, a microbiota-derived proapoptotic peptide, in patients with severe acute cholangitis

Nishiwaki,

Imoto,

Oka

et al. 2023

Gut Pathog

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Background Acute cholangitis is a severe, life-threatening infection of the biliary system that requires early diagnosis and treatment. The Tokyo Guidelines recommend a combination of clinical, laboratory, and imaging findings for diagnosis and severity assessment, but there are still challenges in identifying severe cases that need immediate intervention. The microbiota and its derived products have been implicated in the pathogenesis of acute cholangitis. Corisin is a microbiome-derived peptide that induces cell apoptosis, acute tissue injury, and inflammation. This study aimed to evaluate the potential of plasma and bile corisin as a biomarker of acute cholangitis. Methods Forty patients with acute cholangitis associated with choledocholithiasis or malignant disease were enrolled. Nine patients without acute cholangitis were used as controls. Corisin was measured by enzyme immunoassays in plasma and bile samples. Patients were classified into severe and non-severe groups. The associations of plasma and bile corisin with the clinical grade of acute cholangitis and other parameters were analyzed by univariate and multivariate regression analysis. Results Plasma and bile corisin levels were significantly higher in patients with acute cholangitis than in controls. Patients with severe acute cholangitis had significantly higher plasma and bile corisin levels than those with non-severe form of the disease. Bile corisin level was significantly correlated with markers of inflammation, coagulation, fibrinolysis, and renal function. Univariate analysis revealed a significant association of bile corisin but a weak association of plasma corisin with the clinical grade of acute cholangitis. In contrast, multivariate analysis showed a significant relationship between plasma corisin level and the disease clinical grade. The receiver operating characteristic curve analysis showed low sensitivity but high specificity for plasma and bile corisin to detect the severity of acute cholangitis. The plasma and bile corisin sensitivity was increased when serum C-reactive protein level was included in the receiver operating characteristic curve analysis. Conclusions Overall, these findings suggest that plasma and bile corisin levels may be useful biomarkers for diagnosing and monitoring acute cholangitis and that corisin may play a role in the pathophysiology of the disease by modulating inflammatory, coagulation and renal pathways.

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“…On the other hand, Liu and colleagues 14 reported that the cutoff value of presepsin for diagnosing sepsis was 317 pg/ml, with a sensitivity of 70.8% and specificity of 85.8%, and that the median [25th to 75th percentiles] presepsin concentration in healthy individuals was 130 [104, 179] pg/ml. Tsuchida and colleagues 31 reported the cutoff values of presepsin for detecting bacterial infection and bacteremia in non-severe outpatients were 226 pg/ml (sensitivity 67%, specificity 66%) and 256 pg/ml (sensitivity 84%, specificity 70%), respectively. The latter two studies, as well as our own, suggest that the optimal cutoff value of presepsin to detect an infectious complication may not be as large as expected.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of presepsin for the early detection of infectious complications after elective colorectal surgery, compared with C-reactive protein and procalcitonin

Amanai

Nakai

Saito

et al. 2022

Sci Rep

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Infectious complications remain a major clinical problem in colorectal surgery. Presepsin has been reported to be a useful marker to diagnose sepsis, similar or superior to procalcitonin (PCT) and C-reactive protein (CRP). The aim of this study was to assess the diagnostic value of presepsin in the early detection of infectious complications after elective colorectal surgery, compared with CRP and PCT. This study was a prospective observational study. Patients of age > 18 who underwent elective colon resections were enrolled. Blood samples were collected just before surgery and on postoperative day (POD) 1, 2, 3, 4, and 6 to measure plasma levels of biomarkers. We evaluated the association between circulating biomarkers and infections. A total of 114 patients were examined, and 27 patients (23.7%) developed infectious complications. CRP and PCT markedly increased from POD 1 to POD 3 and then gradually decreased toward POD 6 in both groups, but the trends of the decrease in the infected group were blunt, compared with those in the non-infected group. On the other hand, presepsin did not show major changes just after surgery, but it increased on POD 4 and POD 6, when the complications occurred. Monitoring the presepsin trends after colorectal surgeries could be helpful to detect postoperative infectious complications.Trial registration: UMIN000025313. Registered on 17 December 2016.

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Determining the factors affecting serum presepsin level and its diagnostic utility: A cross-sectional study

Cited by 8 publications

References 22 publications

Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions

Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions

Elevated plasma and bile levels of corisin, a microbiota-derived proapoptotic peptide, in patients with severe acute cholangitis

Usefulness of presepsin for the early detection of infectious complications after elective colorectal surgery, compared with C-reactive protein and procalcitonin

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