Procalcitonin and the Calcitonin Gene Family of Peptides in Inflammation, Infection, and Sepsis: A Journey from Calcitonin Back to Its Precursors

Becker, Kenneth L.; Nylen, Eric; White, Jon; Müller, Beat; Snider, Richard H.

doi:10.1210/jc.2002-021444

Cited by 505 publications

(405 citation statements)

References 155 publications

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“…There are two primary mechanisms that might be responsible for the marked increase in circulating ADM in sepsis. First, ADM is widely expressed and extensively synthesized during sepsis, similar to other calcitonin peptides including procalcitonin and calcitonin-gene related peptides, because ADM is a member of the CALC gene family (18). In a second potential mechanism, decreased clearance by the kidneys may be responsible in part for increased levels in sepsis (17).…”

Section: Discussionmentioning

confidence: 99%

Proadrenomedullin as a prognostic marker in neonatal sepsis

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Proadrenomedullin as a prognostic marker in neonatal sepsis

et al. 2012

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“…12 Procalcitonin (PCT) is a potential marker of acute inflammation that is released from different parenchymal tissues and differentiated cell types throughout the body, mostly from the liver and adipose tissue, in response to interleukin levels increased in case of bacterial infections. [13][14][15][16] The aim of this study is to determine if CRP, LBP, and PCT in drain fluid can serve as noninvasive screening tools for CAL in the early postoperative phase after colorectal surgery.…”

mentioning

confidence: 99%

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Komen

Slieker

Willemsen

et al. 2014

The American Journal of Surgery

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BACKGROUND: We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL).METHODS: Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. RESULTS: In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times.This research was made possible by grant from ''Stichting Technische Wetenschappen'' (STW), Utrecht, The Netherlands. STW had no role in the study design, in collection, analysis and interpretation of the data, in writing of this manuscript or in the decision to submit.

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“…6 Elevated serum procalcitonin levels are associated with bacterial infection when nonbacterial infection or noninfectious disease might also be considered. 7,8 In addition, studies suggest that significant decreases in procalcitonin levels in antibiotic-treated infections indicate treatment success, and can be used as a criterion for discontinuing antibiotic therapy. 6 Procalcitonin testing in CAP might seem logical, given uncertainty in etiologic diagnosis and favorable clinical trial outcomes.…”

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confidence: 99%

Cost-Effectiveness of Procalcitonin-Guided Antibiotic Use in Community Acquired Pneumonia

et al. 2013

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BACKGROUND:Although prior randomized trials have demonstrated that procalcitonin-guided antibiotic therapy effectively reduces antibiotic use in patients with community-acquired pneumonia (CAP), uncertainties remain regarding use of procalcitonin protocols in practice. OBJECTIVE: To estimate the cost-effectiveness of procalcitonin protocols in CAP. DESIGN: Decision analysis using published observational and clinical trial data, with variation of all parameter values in sensitivity analyses. PATIENTS: Hypothetical patient cohorts who were hospitalized for CAP. INTERVENTIONS: Procalcitonin protocols vs. usual care. MAIN MEASURES: Costs and cost per quality adjusted life year gained. KEY RESULTS: When no differences in clinical outcomes were assumed, consistent with clinical trials and observational data, procalcitonin protocols cost $10-$54 more per patient than usual care in CAP patients. Under these assumptions, results were most sensitive to variations in: antibiotic cost, the likelihood that antibiotic therapy was initiated less frequently or over shorter durations, and the likelihood that physicians were nonadherent to procalcitonin protocols. Probabilistic sensitivity analyses, incorporating procalcitonin protocol-related changes in quality of life, found that protocol use was unlikely to be economically reasonable if physician protocol nonadherence was high, as observational study data suggest. However, procalcitonin protocols were favored if they decreased hospital length of stay. CONCLUSIONS: Procalcitonin protocol use in hospitalized CAP patients, although promising, lacks physician nonadherence and resource use data in routine care settings, which are needed to evaluate its potential role in patient care.

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Procalcitonin and the Calcitonin Gene Family of Peptides in Inflammation, Infection, and Sepsis: A Journey from Calcitonin Back to Its Precursors

Cited by 505 publications

References 155 publications

Proadrenomedullin as a prognostic marker in neonatal sepsis

Proadrenomedullin as a prognostic marker in neonatal sepsis

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Cost-Effectiveness of Procalcitonin-Guided Antibiotic Use in Community Acquired Pneumonia

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