Presepsin

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Presepsin (soluble CD14 subtype, sCD14-ST) is a 13-kDa-cleavage product of CD14 receptor. [1]

Contents

Function

Presepsin is a soluble PRR. Presepsin in the circulation is an indicator of monocyte-macrophage activation in response to pathogens. [1]

Clinical relevance

Several clinical studies have demonstrated that presepsin is a specific and sensitive marker for the diagnosis, severity assessment and outcome prediction of sepsis. [2] [3] [4] In addition, presepsin can be used for diagnosing infections in patients with a chronic inflammatory condition, such as liver cirrhosis. [5]

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Hepatitis An inflammation of the liver.

Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pain, and diarrhea. Hepatitis is acute if it resolves within six months, and chronic if it lasts longer than six months. Acute hepatitis can resolve on its own, progress to chronic hepatitis, or (rarely) result in acute liver failure. Chronic hepatitis may progress to scarring of the liver (cirrhosis), liver failure, and liver cancer.

Pneumonia Inflammation of the alveoli of the lungs

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever and difficulty breathing. The severity of the condition is variable.

Hepatitis C Human viral infection

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, abdominal pain, and yellow tinged skin occurs. The virus persists in the liver in about 75% to 85% of those initially infected. Early on chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.

Sepsis Life-threatening organ dysfunction triggered by infection

Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is followed by suppression of the immune system. Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection. The very young, old, and people with a weakened immune system may have no symptoms of a specific infection, and the body temperature may be low or normal instead of having a fever. Severe sepsis causes poor organ function or blood flow. The presence of low blood pressure, high blood lactate, or low urine output may suggest poor blood flow. Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement.

Neutropenia Abnormally low concentration of neutrophils (a type of white blood cell) in the blood

Neutropenia is an abnormally low concentration of neutrophils in the blood. Neutrophils make up the majority of circulating white blood cells and serve as the primary defense against infections by destroying bacteria, bacterial fragments and immunoglobulin-bound viruses in the blood. People with neutropenia are more susceptible to bacterial infections and, without prompt medical attention, the condition may become life-threatening.

Procalcitonin

Procalcitonin (PCT) is a peptide precursor of the hormone calcitonin, the latter being involved with calcium homeostasis. It arises once preprocalcitonin is cleaved by endopeptidase. It was first identified by Leonard J. Deftos and Bernard A. Roos in the 1970s. It is composed of 116 amino acids and is produced by parafollicular cells of the thyroid and by the neuroendocrine cells of the lung and the intestine.

Primary sclerosing cholangitis Medical condition

Primary sclerosing cholangitis (PSC) is a long-term progressive disease of the liver and gallbladder characterized by inflammation and scarring of the bile ducts which normally allow bile to drain from the gallbladder. Affected individuals may have no symptoms or may experience signs and symptoms of liver disease such as yellow discoloration of the skin and eyes, itching, and abdominal pain.

Gastrointestinal bleeding Medical condition

Gastrointestinal bleeding, also called gastrointestinal hemorrhage (GIB), is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool. Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. Other symptoms may include abdominal pain, shortness of breath, pale skin, or passing out. Sometimes in those with small amounts of bleeding no symptoms may be present.

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Chorioamnionitis Medical condition

Chorioamnionitis, also known as intra-amniotic infection (IAI), is inflammation in response to bacterial infection of the fetal membranes: amnion and chorion. The term intrauterine inflammation or infection can be substituted for chorioamnionitis. Chorioamnionitis can not confirm the presence of fever in the mother and is not a medically established enough reason to begin antibiotics, allowing Triple I to encompass a broader spectrum of disease.

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Non-alcoholic fatty liver disease Excessive fat build-up in the liver not caused by alcohol use

Non-alcoholic fatty liver disease (NAFLD), also known as metabolic (dysfunction) associated fatty liver disease (MAFLD), is excessive fat build-up in the liver without another clear cause such as alcohol use. There are two types; non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), with the latter also including liver inflammation. Non-alcoholic fatty liver disease is less dangerous than NASH and usually does not progress to NASH or liver cirrhosis. When NAFLD does progress to NASH, it may eventually lead to complications such as cirrhosis, liver cancer, liver failure, or cardiovascular disease.

Hemophagocytic lymphohistiocytosis Medical condition

Hemophagocytic lymphohistiocytosis (HLH), also known as haemophagocytic lymphohistiocytosis, and hemophagocytic or haemophagocytic syndrome, is an uncommon hematologic disorder seen more often in children than in adults. It is a life-threatening disease of severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages, characterised by proliferation of morphologically benign lymphocytes and macrophages that secrete high amounts of inflammatory cytokines. It is classified as one of the cytokine storm syndromes. There are inherited and non-inherited (acquired) causes of hemophagocytic lymphohistiocytosis (HLH).

Lipocalin-2

Lipocalin-2 (LCN2), also known as oncogene 24p3 or neutrophil gelatinase-associated lipocalin (NGAL), is a protein that in humans is encoded by the LCN2 gene. NGAL is involved in innate immunity by sequestering iron and preventing its use by bacteria, thus limiting their growth. It is expressed in neutrophils and in low levels in the kidney, prostate, and epithelia of the respiratory and alimentary tracts. NGAL is used as a biomarker of kidney injury.

CD163

CD163 is a protein that in humans is encoded by the CD163 gene. CD163 is the high affinity scavenger receptor for the hemoglobin-haptoglobin complex and in the absence of haptoglobin - with lower affinity - for hemoglobin alone. It also is a marker of cells from the monocyte/macrophage lineage. CD163 functions as innate immune sensor for gram-positive and gram-negative bacteria. The receptor was discovered in 1987.

TREM1

Triggering receptor expressed on myeloid cells 1 (TREM-1) is a protein that in humans is encoded by the TREM1 gene.

Cirrhosis Chronic disease of the liver, characterized by fibrosis

Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis, due to damage caused by liver disease. Damage causes tissue repair and subsequent formation of scar tissue, which over time can replace normal functioning tissue leading to the impaired liver function of cirrhosis. The disease typically develops slowly over months or years. Early symptoms may include tiredness, weakness, loss of appetite, unexplained weight loss, nausea and vomiting, and discomfort in the right upper quadrant of the abdomen. As the disease worsens, symptoms may include itchiness, swelling in the lower legs, fluid build-up in the abdomen, jaundice, bruising easily, and the development of spider-like blood vessels in the skin. The fluid build-up in the abdomen may become spontaneously infected. More serious complications include hepatic encephalopathy, bleeding from dilated veins in the esophagus, stomach or intestines, and liver cancer.

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References

  1. 1 2 Chenevier-Gobeaux C, Borderie D, Weiss N, Mallet-Coste T, Claessens YE (October 2015). "Presepsin (sCD14-ST), an innate immune response marker in sepsis". Clinica Chimica Acta; International Journal of Clinical Chemistry. 450: 97–103. doi:10.1016/j.cca.2015.06.026. PMID   26164388.
  2. Dupuy AM, Philippart F, Péan Y, Lasocki S, Charles PE, Chalumeau M, et al. (July 2013). "Role of biomarkers in the management of antibiotic therapy: an expert panel review: I - currently available biomarkers for clinical use in acute infections". Annals of Intensive Care. 3 (1): 22. doi:10.1186/2110-5820-3-22. PMC   3708786 . PMID   23837559.
  3. Tong X, Cao Y, Yu M, Han C (2015). "Presepsin as a diagnostic marker for sepsis: evidence from a bivariate meta-analysis". Therapeutics and Clinical Risk Management. 11: 1027–33. doi:10.2147/TCRM.S84811. PMC   4494627 . PMID   26170681.
  4. Wu J, Hu L, Zhang G, Wu F, He T (2015). "Accuracy of Presepsin in Sepsis Diagnosis: A Systematic Review and Meta-Analysis". PLOS ONE. 10 (7): e0133057. Bibcode:2015PLoSO..1033057W. doi:10.1371/journal.pone.0133057. PMC   4507991 . PMID   26192602.
  5. Papp M, Tornai T, Vitalis Z, Tornai I, Tornai D, Dinya T, et al. (November 2016). "Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis". World Journal of Gastroenterology. 22 (41): 9172–9185. doi:10.3748/wjg.v22.i41.9172. PMC   5107598 . PMID   27895404.