Late pulmonary sequela following burns: persistence of hyperprocalcitonemia using a 1–57 amino acid N-terminal flanking peptide assay

Nylen, Eric; Jeng, Jun-Jang; Jordan, Marion H.; Snider, Richard H.; Thompson, Kenneth; Lewis, Mark S.; O’Neill, William; Becker, K. L.

doi:10.1016/0954-6111(95)90069-1

Cited by 25 publications

(12 citation statements)

References 18 publications

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“…Other than infection, PCT levels increase in premature infants, hypoxia, RDS, and hemodynamic instability, decreasing its specificity in early-onset sepsis10,11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Research studies reported that PCT is more effective than CRP at follow-up, as PCT levels rise earlier and return to normal levels more rapidly than CRP levels2,3,4,5,6,7,8,9). However, some studies have shown a decrease in PCT specificity associated with an increase in uninfected preterm babies, hypoxia, neonatal respiratory distress syndrome (RDS), and hematologic failure10,11,12). Furthermore, one report suggested that PCT is only significant when used in combination with other tests, and it is not appropriate for diagnosing sepsis13).…”

Section: Introductionmentioning

confidence: 99%

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Serum procalcitonin as a diagnostic marker of neonatal sepsis

Lee

2014

Korean J Pediatr

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PurposeWe evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels.MethodsWe retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values.ResultsThe mean PCT and CRP concentrations were respectively 56.27±81.89 and 71.14±37.17 mg/L in the "confirmed sepsis" group; 15.64±32.64 and 39.23±41.41 mg/L in the "suspected sepsis" group; 9.49±4.30 and 0.97±1.16 mg/L in the "mild infection" group; and 0.21±0.12 and 0.72±0.7 mg/L in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively).ConclusionPCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

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“…Other than infection, PCT levels increase in premature infants, hypoxia, RDS, and hemodynamic instability, decreasing its specificity in early-onset sepsis10,11,12).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum procalcitonin as a diagnostic marker of neonatal sepsis

Lee

2014

Korean J Pediatr

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“…Currently, there is no available assay that detects ProCT exclusively. Initially, for the purpose of studying systemic infection, inflammation and sepsis, a very sensitive, single‐antibody assay of NProCT was developed for research purposes (Nylén et al. , 1995; Snider et al.…”

Section: Proctmentioning

confidence: 99%

Procalcitonin in sepsis and systemic inflammation: a harmful biomarker and a therapeutic target

Becker

Snider

Nylen

2010

British J Pharmacology

236

221

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The worldwide yearly mortality from sepsis is substantial, greater than that of cancer of the lung and breast combined. Moreover, its incidence is increasing, and its response to therapy has not appreciably improved. In this condition, the secretion of procalcitonin (ProCT), the prohormone of calcitonin, is augmented greatly, attaining levels up to thousands of fold of normal. This hypersecretion emanates from multiple tissues throughout the body that are not traditionally viewed as being endocrine. The serum values of ProCT correlate with the severity of sepsis; they recede with its improvement and worsen with exacerbation. Accordingly, as highlighted in this review, serum ProCT has become useful as a biomarker to assist in the diagnosis of sepsis, as well as related infectious or inflammatory conditions. It is also a useful monitor of the clinical course and prognosis, and sensitive and specific assays have been developed for its measurement. Moreover, it has been demonstrated that the administration of ProCT to septic animals greatly increases mortality, and several toxic effects of ProCT have been elucidated by in vitro experimental studies. Antibodies have been developed that neutralize the harmful effects of ProCT, and their use markedly decreases the symptomatology and mortality of animals that harbour a highly virulent sepsis analogous to that occurring in humans. This therapy is facilitated by the long duration of serum ProCT elevation, which allows for a broad window of therapeutic opportunity. An experimental groundwork has been established that suggests a potential applicability of such therapy in septic humans.

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“…For the measurement of calcitonin precursors, we used a sensitive radioimmunoassay that utilizes an antiserum to the amino portion of the prohormone. It detects both aminoprocalcitonin and the intact procalcitonin molecule [11,13,28]. This assay has the advantage of a sensitivity of 0´65 pmol L À1 , and detects values in nearly all normal persons (reference range: 2±12 pmol L À1 ).…”

Section: Laboratory Measurementsmentioning

confidence: 99%