Meet Gentian at Weimar Sepsis Update 2023

At the 11^th Weimar Sepsis Update on September 06-08^th the German Sepsis Society spotlights the situation of the critical care community that has been confronted with the Corona pandemic. SARS-CoV-2 as a new pathogen has expanded the diverse range of sepsis pathogens.

Meet Gentian Diagnostics at booth #34 to learn more about plasma and serum calprotectin in severe infections and sepsis, including severe form of COVID-19.

Plasma and serum calprotectin in the ED and ICU

Gentian Diagnostics has developed a calprotectin immunoassay - GCAL^® - for quantitative determination of calprotectin in plasma and serum intended as an aid in detection and assessment of inflammation and inflammatory response to infections.

The value of plasma and serum calprotectin has been investigated in several studies performed in emergency departments (ED) and intensive care units (ICU), focusing on the biomarker's role in diagnosis and assessment of disease severity, as well as in prediction of clinical deterioration. Several studies with the GCAL^® assay have been published with focus on bacterial infections, sepsis and COVID-19.

Read some of the published GCAL^® studies here:

Bacterial sepsis

Plasma calprotectin as an indicator of need of transfer to intensive care in patients with suspected sepsis at the emergency department.
Parke Å et al. BMC Emerg Med. 2023

Analysis of Calprotectin as an Early Marker of Infections Is Economically Advantageous in Intensive Care-Treated Patients.
Havelka A et al. Biomedicines. 2023

Calprotectin is superior to procalcitonin as a sepsis marker and predictor of 30-day mortality in intensive care patients.
Larsson A et al. Scand J Clin Lab Invest. 2020

Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment.
Jonsson N et al. J. Crit Care Resusc. 2017

SARS-CoV-2

Circulating levels of calprotectin, a signature of neutrophil activation in prediction of severe respiratory failure in COVID-19 patients: a multicenter, prospective study (CalCov study).
García de Guadiana-Romualdo L et al. Inflamm Res. 2022

Outcome prediction by serum calprotectin in patients with COVID-19 in the emergency department.
Bauer W et al. J Infect. 2021

Circulating levels of GDF-15 and calprotectin for prediction of in-hospital mortality in COVID-19 patients: A case series
Luis García de Guadiana Romualdo et al. J Infect. 2021

Calprotectin in severe infections and sepsis

The biomarker calprotectin is an inflammatory and anti-microbial protein released by neutrophils in response to infection. The biomarker has shown to increase in bacterial infections within only a few hours.¹

Elevated calprotectin levels can predict severe events, clinical course, and mortality in septic patients^2-5 and improve classical risk scoring.⁶ Early detection and risk stratification at the emergency department can thereby help to identify patients at risk for deterioration and guide decisions on course of treatment and necessary transfer of patients to ICU.⁷ This makes calprotectin an early and sensitive biomarker, and an ideal candidate for assessment of risk for severe infections and sepsis.

Calprotectin has shown to be able to distinguish between viral and bacterial infection^8-10, which can aid in decision making and the course of treatment and antibiotic use. Importantly, calprotectin can predict bacterial infections even before the appearance of clinical symptoms.¹¹ Consequently, measuring calprotectin can reduce total costs, shorten the average duration of in-patient care, and lower mortality rates.¹²

Calprotectin in acute infection and sepsis - Innovation theatre recording 

In this recording Dr. Wolfgang Bauer, PI of the trial with title “Calprotectin in Acute Infections and Sepsis for Prognosis, Characterisation and Diagnosis in the Emergency Department” (CASCADE-Trial) presents results from the study and discuss the value of calprotectin for diagnosis and management of acute infections and sepsis in the ED.

Calprotectin in SARS-CoV-2 infection - sepsis and upregulated neutrophils

SARS-CoV-2 has been described to cause viral sepsis^13-16, and the reported diagnostic value of calprotectin in SARS-CoV-2 infection is related to the hyperinflammatory response in severe COVID-19 leading to viral sepsis.^13-26 Calprotectin levels are elevated in severe compared to mild cases and has been demonstrated to correlate with and predict various clinical outcomes, such as oxygenation status, mechanical ventilation need, ICU admission, multiorgan failure (MOF), and mortality.^19-25,27

Neutrophils are upregulated and activated in COVID-19 patients as potential driver of disease severity.^28-30 Hospitalised COVID-19 patients with severe form of the disease show dysregulated immune response and induction of cytokine response (also called cytokine storm or hyperinflammation), which is a reaction very similar to bacterial sepsis.^18,30-32

Following the pathology of neutrophil activation and hyperinflammation in COVID-19, it is conceivable that calprotectin is a sensitive risk marker both in the viral infection resulting in severe COVID-19 and bacterial infections. Calprotectin’s value lies within an early risk assessment and prediction of severe events, and thereby aid to prevent developing sepsis.

GCAL® - Plasma and serum calprotectin

The GCAL^®  assay is intended for quantitative determination of calprotectin in plasma and serum as an aid in detection and assessment of inflammation and inflammatory response to infections. GCAL^® is a novel Particle-Enhanced Turbidimetric Immunoassay (PETIA) that can be applied on a wide range of automated clinical chemistry analysers.

The GCAL^® immunoassay is developed and manufactured by Gentian. GCAL^® is CE-marked and IVDR certified. The assay might not be registered for use in your country of residence and may not comply with applicable laws or regulations in that country. The assay is not cleared for use in the USA (RUO only).

Contact us for further information

Explore GCAL^® at your hospital and clinical practice - fill out the form or send an email to marketing@gentian.com for more information about the product and validation.

References:

1. Fullerton J et al. Kinetics of calprotectin, procalcitonin and C-reactive protein in healthy volunteers administered intravenous endotoxin. 40th International Symposium on Intensive Care & Emergency Medicine. Critical Care. 2020. P474
2. Larsson, A et al. Calprotectin is superior to procalcitonin as a sepsis marker and predictor of 30-day mortality in intensive care patients. Scand J Clin Lab Invest, 2019
3. Gao, S et al. Diagnostic and prognostic value of myeloid-related protein complex 8/14 for sepsis. Am J Emerg Med, 2015
4. Parke, Å et al. 40th International Symposium on Intensive Care & Emergency Medicine. Critical Care, 2020
5. Wirtz, TH et al. Association of Serum Calprotectin Concentrations with Mortality in Critically Ill and Septic Patients. Diagnostics (Basel), 2020
6. Dubois, C et al. High plasma level of S100A8/S100A9 and S100A12 at admission indicates a higher risk of death in septic shock patients. Scientific Reports, 2019
7. Parke, Å et al. Plasma calprotectin as an indicator of need of transfer to intensive care in patients with suspected sepsis at the emergency department. BMC Emerg Med, 2023
8. Havelka, A et al. Calprotectin, a new biomarker for diagnosis of acute respiratory infections. Scientific reports, 2020
9. Siljan, WW et al. Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study. ERJ Open Res, 2019
10. Bartáková, E et al. Calprotectin and calgranulin C serum levels in bacterial sepsis. Diagn Microbiol Infect Dis, 2019
11. Jonsson, N et al. Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment. Crit Care Resusc, 2017
12. Havelka, A et al. Analysis of Calprotectin as an Early Marker of Infections Is Economically Advantageous in Intensive Care-Treated Patients. Biomedicines, 2023
13. Vincent, JL. COVID-19: it's all about sepsis. Future Microbiol, 2021
14. Odabasi, Z et al. Consideration of Severe Coronavirus Disease 2019 As Viral Sepsis and Potential Use of Immune Checkpoint Inhibitors. Crit Care Explor, 2020
15. Shappell, CN et al. Does Severe Acute Respiratory Syndrome Coronavirus 2 Cause Sepsis? Crit Care Med, 2020
16. Liu, D et al. Viral sepsis is a complication in patients with Novel Corona Virus Disease (COVID-19). Med Drug Discov, 2020
17. López-Collazo, E et al. Immune Response and COVID-19: A mirror image of Sepsis. Int J Biol Sci, 2020
18. Li, H et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet, 2020
19. de Guadiana-Romualdo, L et al. Circulating levels of calprotectin, a signature of neutrophil activation in prediction of severe respiratory failure in COVID-19 patients: a multicenter, prospective study (CalCov study). Inflamm Res, 2021
20. Shi, H et al. Neutrophil calprotectin identifies severe pulmonary disease in COVID-19. Journal of Leukocyte Biology, 2020
21. Chen, L et al. Elevated serum levels of S100A8/A9 and HMGB1 at hospital admission are correlated with inferior clinical outcomes in COVID-19 patients. Cell Mol Immunol, 2020
22. Udeh, R et al. Calprotectin, an Emerging Biomarker of Interest in COVID-19: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 2021
23. Shu, T et al. Plasma Proteomics Identify Biomarkers and Pathogenesis of COVID-19. Immunity, 2020
24. Silvin, A, et al. Elevated Calprotectin and Abnormal Myeloid Cell Subsets Discriminate Severe from Mild COVID-19. Cell, 2020
25. Bauer, W et al. Outcome prediction by serum calprotectin in patients with COVID-19 in the emergency department. J Infect, 2020
26. Giuffrè, M et al. Calprotectin and SARS-CoV-2: A Brief-Report of the Current Literature. Healthcare (Basel), 2021
27. de Guadiana Romualdo, LG et al. Circulating levels of GDF-15 and calprotectin for prediction of in-hospital mortality in COVID-19 patients: A case series. J Infect, 2020
28. Zuo, Y et al. Neutrophil extracellular traps in COVID-19. JCI Insight, 2020
29. Barnes, BJ et al. Targeting potential drivers of COVID-19: Neutrophil extracellular traps. J Exp Med, 2020
30. Guo, Q et al. Induction of alarmin S100A8/A9 mediates activation of aberrant neutrophils in the pathogenesis of COVID-19. Cell Host Microbe, 2020
31. Beltrán-García, J et al. Sepsis and Coronavirus Disease 2019: Common Features and Anti-Inflammatory Therapeutic Approaches. Critical care medicine, 2020
32. Wilson, JG et al. Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis. JCI Insight, 2020