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Usefulness of Presepsin (Soluble CD14 Subtype) as a Diagnostic Marker of Sepsis in Egyptian Patients with Acute Myeloid Leukemia

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Background: Systemic inflammatory response syndrome (SIRS) is a systemic inflammatory response to a variety of insults. Presepsin; the soluble CD14 subtype is a novel soluble CD14 molecule that is useful for diagnosing sepsis. It plays an important role in modulating the immune response to endotoxin in vitro and vivo. The aim: Of the study was to evaluate the usefulness of presepsin as a diagnostic marker of sepsis in acute leukemia. Methods: The current study was carried out on 40 adult patients with acute myeloid leukemia after receiving chemotherapy. 10 clinically normal individuals were included in the study to measure the level of presepsin. Results: This study was conducted on 50 individuals divided into 2 groups. Group I included 40 adult AML patients who fulfilled at least two of the diagnostic criteria for SIRS and Group II were 10 healthy adult persons as a control group. In Group I there were 11 patients (27.5%) having SIRS, 8 (20%) having sepsis, 9 (22.5%) having severe sepsis and 12 (30%) having septic shock. Data indicate that presepsin level was significantly higher in patients than control P = 0.017. Our results showed that the level of presepsin has a significantly positive correlation to the degree of severity of sepsis with P value 0.0001. Using the ROC curve, we found that presepsin was more specific than CRP in detection of sepsis. Conclusion: sCD14-ST (presepsin) is a new important marker for diagnosis and prognosis of sepsis. Its level increases in the first six hours after the onset of sepsis. Our data demonstrated that the concentration of presepsin is specifically increased during sepsis and is directly proportional to the degree of sepsis. Regarding sensitivity and specificity of presepsin in the discrimination of sepsis patients from healthy controls, a high specificity but low sensitivity was reported by most of the studies.
Cite this paper
Maurice, M. , Nafea, D. , Sawy, M. , Soelam, R. and Youssef, S. (2014) Usefulness of Presepsin (Soluble CD14 Subtype) as a Diagnostic Marker of Sepsis in Egyptian Patients with Acute Myeloid Leukemia. American Journal of Molecular Biology, 4, 169-176. doi: 10.4236/ajmb.2014.44019
 

[1] Lichtman, M.A. and Liesveld, J.L. (2001) Acute Myelogenous Leukemia. In: Beutler, E., Lichtman, M.A., Coller, B.S., Kipps, T.J. and Seligsohn, U., Eds., Williams Hematology, 6th Edition, McGraw-Hill Company, New York, St. Louis, 1074-1083.
[2] Gilliland, D.G. (2001) Hematologic Malignancies. Current Opinion in Hematology, 8, 189-191.
http://dx.doi.org/10.1097/00062752-200107000-00001
[3] Freifeld, A.G., Bow, E.J., Sepkowitz, K.A., et al. (2011) Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 52, e56. http://dx.doi.org/10.1093/cid/cir073
[4] Viscoli, C., Varnier, O. and Machetti, M. (2005) Infections in Patients with Febrile Neutropenia: Epidemiology, Microbiology, and Risk Stratification. Clinical Infectious Diseases, 40, S240.
http://dx.doi.org/10.1086/427329
[5] Bone, R.C., Balk, R.A., Cerra, F.B., Dellinger, R.P., Fein, A.M., Knaus, W.A., et al. (1992) Definitions for Sepsis and Organ Failure and Guidlines for the Use of Innovative Therapies in Sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest, 101, 1644-1655.
[6] Levy, M.M., Fink, M.P., Marshall, J.C., Abraham, E., Angus, B., Cook, D., et al. (2001) SCCM/ESICM/AGCP/ATS/ SIS International Sepsis Definitions Conference. Critical Care Medicine, 31, 1250-1256.
[7] Okamura, Y. and Yokoi, H. (2011) Development of a Point-of-Care Assay System for Measurement of Presepsin (sCD14-ST). Clinica Chimica Acta, 412, 2157-2161.
[8] Wright, S.D., Ramos, R.A., Tobias, P.S., et al. (1990) CD14, a Receptor for Complexes of Lipopolysaccharide (LPS) and LPS Binding Protein. Science, 249, 1431-1433.
[9] Antal-Szalmas, P., Van Strijp, J.A.G., Weersink, A.J.L., Verhoef, J. and Van Kessel, K.P.M. (1997) Quantitation of Surface CD14 on Human Monocytes and Neutrophils. Journal of Leukocyte Biology, 61, 721-728.
[10] Liu, S., Khemlani, L.S., Shapiro, R.A., Johnson, M.L., Liu, K., Geller, D.A., Watkins, S.C., Goyert, S.M. and Billiar, T.R. (1998) Expression of CD14 by Hepatocytes: Upregulation by Cytokines during Endotoxemia. Infection and Immunity, 66, 5089-5098.
[11] Peterson, P.K., Gekker, G., Hu, S., Sheng, W.S., Anderson, W.R., Ulevitch, R.J., Tobias, P.S., Gustafson, K.V., Molitor, T.W. and Ghao, C.C. (1995) CD14 Receptor-Mediated Uptake of Nonopsonized Mycobacterium tuberculosis by Human Microglia. Infection and Immunity, 63, 1598-1602.
[12] Sugawara, S., Sugiyama, A., Nemoto, E., Rikiishi, H. and Takada, H. (1998) Heterogeneous Expression and Release of CD14 by Human Gingival Fibroblasts: Characterization and CD14-Mediated Interleukin-8 Secretion in Response to Lipopolysaccharide. Infection and Immunity, 66, 3043-3049.
[13] Ziegler-Heitbrock, H.W.L., Pechumer, H., Petersmann, I., Durieux, J.J., Vita, N., Labeta, M.O. and Strobel, M. (1994) CD14 Is Expressed and Functional in Human B Cells. European Journal of Immunology, 24, 1937-1940. http://dx.doi.org/10.1002/eji.1830240835
[14] Leturcq, D.J., Moriarty, A.M., Talbott, G., et al. (1996) Antibodies against CD14 Protect Primates from Endotoxin-Induced Shock. Journal of Clinical Investigation, 98, 1533-1538.
http://dx.doi.org/10.1172/JCI118945
[15] Pugin, J., Ulevitch, R.J. and Tobias, P.S. (1995) Activation of Endothelial Cells by Endotoxin: Direct Versus Indirect Pathways and the Role of GD 14. Progress in Clinical Biological Research, 392, 369-373.
[16] Schimke, S., Mathison, J., Morgiewicz, J., et al. (1998) Anti-CD14 mAb Treatment Provides Therapeutic Benefit after in Vivo Exposure to Endotoxin. Proceedings of the National Academy of Sciences of the United States of America, 95, 13875-13880. http://dx.doi.org/10.1073/pnas.95.23.13875
[17] Ulevitch, R.J., Dunn, D.L., Fink, M.P., et al. (1996) Endotoxin-Related Intracellular Pathways: Implications for Therapeutic Intervention. Shock, 6, 1-2.
http://dx.doi.org/10.1097/00024382-199607000-00001
[18] Yu, B., Hailman, E. and Wright, S.D. (1997) Lipopolysaccharide Binding Protein and Soluble CDI4 Catalyze Exchange of Phospholipids. Journal of Clinical Investigation, 99, 315-324.
http://dx.doi.org/10.1172/JCI119160
[19] Yaegashi, Y., Shirakawa, K., Sato, N., et al. (2005) Evaluation of a Newly Identified Soluble CD14 Subtype as a Marker for Sepsis. Journal of Infection and Chemotherapy, 11, 234-238.
http://dx.doi.org/10.1007/s10156-005-0400-4
[20] Endo, S., Yaegashi, Y., Sato, N., et al. (2005) Usefulness of Soluble CD14 Subtype Which as Is a New Diagnostic Marker for Sepsis. Japanese Journal of Critical Care Endotoxemia, 9, 46-50. (In Japanese)
[21] Takahashi, G., Suzuki, Y., Kojika, M., et al. (2010) Evaluation of Responses to IVIG Therapy in Patients with Severe Sepsis and Septic Shock by Soluble CD14 Subtype Monitoring. Medical Postgraduates, 48, 19-24.
[22] Shozushima, T., Kojika, M., Takahashi, G., et al. (2010) Evaluation of Presepsin by a Point-of-Care Test (POC Test) Closely Reflect the Efficacy of Polymyxin-B Immobilized Fiber-Direct Hemoperfusion (PMX-DHP): A Case Report. The Journal of the Iwate Medical Association, 62, 411-416.
[23] Shozushima, T., Suzuki, Y., Kojika, M., et al. (2011) Soluble CDI4 Subtype Level Well Reflects the Results of Polymyxin-B Immobilized Fiber-Direct Hemoperfusion (PMX-DHP). Japanese Journal of Critical Care Endotoxemia, 15, 116-121. (In Japanese)
[24] La Porta, A.D., Bowden, A.S. and Barr, S. (2004) Workflow Improvement and Impact of the New Beckman Coulter LII 1500 High Throughput Automated Hematology Workcell. Laboratory Hematology, 10, 95-101. http://dx.doi.org/10.1532/LH96.04022
[25] Beckman Coulter Synchron Clinical System Chemistry Information Manual, 2007.
[26] Stevens, L.A. and Levey, A.S. (2005) Measurement of Kidney Function. In: Singh, A.K., Ed., Medical Clinics of North America, W.B. Saunders, Philadelphia, 457.
[27] Islam, A. (1991) New Sternal Puncture Needle. Journal of Clinical Pathology, 44, 690-691.
[28] Michels, S.D., McKenna, R.W., Arthur, D.C. and Brunning, R.D. (1985) Therapy-Related Acute Myeloid Leukemia and Myelodysplastic Syndrome: A Clinical and Morphologic Study of 65 Cases. Blood, 65, 1364-1372.
[29] Roberts, W.L., Moulton, L. and Law, T.C. (2001) Evaluation of Nine Automated High-Sensitivity C-Reactive Protein Methods: Implications for Clinical and Epidemiological Applications. Part 2. Clinical Chemistry, 47, 418-425.
[30] Spanuth, E., Ebelt, H., Ivandic, B. and Werdan, K. (2011) Diagnostic and Prognostic Value of Presepsin (Soluble CD14 Subtype) in Emergency Patients with Early Sepsis Using the New Assay PATHFAST Presepsin. Proceedings of 21st International Congress of Clinical Chemistry and Laboratory Medicine, IFCC-WorldLab-EuroMedLab, Berlin, 15-19 May 2011.
[31] Povoa, P., Coelho, L., Almeida, E., Fernandes, A., Mealha, R., Moreira, P. and Sabino, H. (2005) C-Reactive Protein as a Marker of Infection in Critically Ill Patients. Clinical Microbiology and Infection, 11, l01-108. http://dx.doi.org/10.1111/j.1469-0691.2004.01044.x
[32] Hofer, N., Zacharias, B., Muller, W. and Resch, B. (2012) An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks. Neonatology, 102, 25-36.
http://dx.doi.org/10.1159/000336629
[33] Nakamura, A., Wada, H., Ikejiri, M., Hatada, T., Sakurai, H., Matsushima, Y., Nishioka, J., Maruyama, K., Isaji, S., Takeda, T. and Nobori, T. (2009) Efficacy of Procalcitonin in the Early Diagnosis of Bacterial Infections in a Critical Care Unit. Shock, 3l, 587-592.
http://dx.doi.org/10.1097/SHK.0b013e31819716fa
[34] Tang, B.M.P., Eslick, G.D., Craig, S.C. and McLean, A.S. (2007) Accuracy of Procalcitonin for Sepsis Diagnosis in Critically Ill Patients: Systematic Review and Meta-Analysis. The Lancet Infectious Diseases, 7, 210-217. http://dx.doi.org/10.1016/S1473-3099(07)70052-X
[35] Yaegashi, Y., Sato, N., Suzuki, Y., Kojika, M., Imai, S., Takahashi, G., Miyata, M. and Endo, S. (2005) Evaluation of a Newly Identified Soluble CDI4 Subtype as a Marker for Sepsis. Journal of Infection and Chemotherapy, 11, 234-238. http://dx.doi.org/10.1007/s10156-005-0400-4
[36] Endo, S., Takahashi, G., Shozushima, T., Matsumoto, N., Kojika, M., Suzuki, Y. and Inoue, Y. (2012) Usefulness of Presepsin (Soluble CD14 Subtype) as a Diagnostic Marker for Sepsis. Journal of Japanese Association for Acute Medicine, 23, 27-38.
[37] Shozushima, T., Takahashi, G., Matsumoto, N., Kojika, M., Okamura, Y. and Endo, S. (2011) Usefulness of Presepsin (sCD14-ST) Measurements as a Marker for the Diagnosis and Severity of Sepsis That Satisfied Diagnostic Criteria of Systemic Inflammatory Response Syndrome. Journal of Infection and Chemotherapy, 17, 764-769. http://dx.doi.org/10.1007/s10156-011-0254-x
[38] Nishida, T., Ishikura, H., Murai, A., Irie, Y., Yuge, R., Kamitani, T. and Endo, S. (2012) Assessment of the Usefulness of Presepsin (Soluble CD14 Subtype) in Septic Patients. Critical Care, 16, 32.      eww141024lx

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