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

Abstract

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.

The Evaluation of Important Biomarkers in Healthy Cattle

“…According to studies, procalcitonin in bacterial diseases is reported to increase rapidly in a short time after TNF-α, IL-6 and IL-8. It is known by various researchers that in septicemias, procalcitonin could increase as one hundred times more than normal serum levels [2,[15][16][17][18] .…”

“…It is demonstrated with various studies that the determination of serum procalcitonin amount caused by bacterial inflammations compared to other cytokines is more specific and sensitive [2,[15][16][17][18][25][26][27] .…”

Increasing Procalcitonin Level of Blunt Thoracoabdominal Trauma Patients with ISS ≥ 16 in Saiful Anwar General Hospital Malang

“…4 Previous studies found that there were increasing level of procalcitonin in trauma patients. 4,8,9,10 It had peak concentration after trauma on the first and third day. 4 It is thought that procalcitonin can be used to observe inflammatory status on trauma patients.…”

Postmortem chemistry update part II

“…Systemic inflammatory syndrome of non-infectious etiologies also leads to increases in serum PCT levels though increased serum PCT levels may be present without any evidence of severe infection in patients subsequent to major trauma or surgery as well as postcardiopulmonary bypass. However, the median values under these conditions are usually lower than those found during severe sepsis and septic shock [68][69][70][71][72][73][74].…”