Diagnostic value of monocyte chemoattractant Protein-1, soluble mannose receptor, Presepsin, and Procalcitonin in critically ill children admitted with suspected sepsis

Abstract

Introduction The differentiation between systemic inflammatory response syndrome and sepsis is very important as it determines essential treatment decisions, such as selection, initiation, and duration of antibiotic therapy. Objectives We aimed to investigate the diagnostic value of Procalcitonin, Monocyte Chemoattractant Protein-1, soluble Mannose Receptor, Presepsin as early biomarkers of pediatric sepsis in comparison to systemic inflammatory response syndrome in severely ill children. Patients and methods This study included 58 children diagnosed as sepsis (group 1), 24 children with systemic inflammatory response syndrome without infection (group 2), and 50 healthy children as controls (group 3). All the plasma levels of the studied biomarkers were measured and ROC curves were created for all the tested parameters to discriminate between sepsis and SIRS. Results The area under the curve for Monocyte Chemoattractant Protein-1 was 0.926 (0.846-0.927) with sensitivity 100% and specificity 62.5%. The soluble Mannose Receptor had the highest sensitivity (100%), with AUC equals 1(.0.956-1.0) and specificity of 100%. The cut-off values for Procalcitonin, Presepsin, soluble Mannose Receptor, and Monocyte Chemoattractant Protein-1 and were: 0.62 ng/ml, 100 pg/ml, 13 ng/ml and 90 pg/ml, respectively. In septic cases, both soluble Mannose Receptor and Procalcitonin have positive correlations with the severity of sepsis, low Glasgow Coma Scale, ventilatory support, use of inotropic drugs and mortality rate (r = 0.950, 0.812, 0.795, 0.732 and 0.861respectively) for soluble Mannose Receptor and (0.536, 0.473, 0.422, 0.305 and 0.474 respectively) for Procalcitonin. Conclusion Soluble Mannose Receptor, Presepsin, and Monocyte Chemoattractant Protein-1 can be used to differentiate between sepsis and SIRS in critically ill children.

Inflammatory Biomarker Profiles in Very Preterm Infants within the Context of Preeclampsia, Chorioamnionitis, and Clinically Diagnosed Postnatal Infection

“…In our study, infants that were born following pregnancies complicated by clinically suspected infection or histopathologically proven chorioamnionitis had the lowest MCP-1 levels. This contrasts with previous reports showing elevation of MCP-1 in older pediatric patients with sepsis [ 22 ], but it is consistent with the chorioamnionitis-induced immune hypo-responsiveness that has been described in several studies [ 12 , 23 , 24 ]. The etiology of the hypo-responsive transcriptional phenotype of perinatal monocytes has not been fully elucidated [ 24 ], but ovine studies suggest the development of endotoxin cross-tolerance following repeated exposure to intra-amniotic cytokines, as elaborated during the evolution of chorioamnionitis [ 25 ].…”

Soluble mannose receptor: A potential biomarker in Gaucher disease

“…Some have argued that sMR may be a better biomarker of inflammation than CRP, sCD163 or procalcitonin. 40,41 Evaluation of sMR in patients with GD is logical given the evidence of its elevation in conditions of significant inflammation, particularly when macrophage activation is increased. Though our understanding of the pathophysiology of GD has evolved to be more inclusive of multiple domains of immune dysregulation, altered macrophage morphology, activation and interaction with the microenvironment is still a significant part of the disease process.…”

“…sMR concentration correlates with disease severity and mortality. Some have argued that sMR may be a better biomarker of inflammation than CRP, sCD163 or procalcitonin 40,41 …”

Serum cytokines in second trimester pregnancy and their relationship with spontaneous preterm births in the Ribeirão Preto and São Luiz cohorts

“…In the study by Sullivan et al 2002, the cutoff value for serum cytokine in preterm infants was defined as around 250 pg/ml. In another study from 2021 but on the serum cytokine MCP1 the cut-off values of normal children are around 150 ng/ml and in this work several cytokines were compared with children with sepsis [ 23 ] it is also worth remembering that we are talking about very specific cytokines that there are not many articles in the literature, especially when it comes to spontaneous preterm births. Immune modulation systematically expressed throughout a pregnancy result in less complicated deliveries than spontaneous preterm deliveries, including data from women who smoke confirm this trend of complications in childbirth [ 24 , 25 ].…”