The value of circulating calprotectin in the ED - Results from the CASCADE trial

18. Jun 2024 | 8 min read

The value of circulating calprotectin in the ED - Results from the CASCADE trial

Calprotectin in acute infections and sepsis for prognosis, characterisation, and diagnosis in the emergency department

We are pleased to inform about the publication of the results from the prospective CASCADE trial.

The clinical trial in collaboration with Charité – Universitätsmedizin Berlin and Labor Berlin included the Gentian GCAL® Calprotectin immunoassay for plasma and serum.

The CASCADE (“Calprotectin in Acute Infections and Sepsis for Prognosis, Characterisation, and Diagnosis in the Emergency Department”) trial is the first large-scale, prospective evaluation of calprotectin as a biomarker for bacterial infections and sepsis in the emergency department (ED), combining infection identification and estimation of the disease outcome and severity.

Read the full text pf the publication here


Blood calprotectin as a biomarker for infection and sepsis - the prospective CASCADE trial

This prospective, observational trial enrolled 395 patients with suspected infection to evaluate the accuracy of calprotectin at the ED for detecting bacterial infections, estimating disease severity, and predicting clinical deterioration.

Highest calprotectin levels were measured in the bacterial infection group independent of infection site, compared to patients with viral infections or no infections. For diagnosing bacterial infections, calprotectin showed notable accuracy independent of age, immunosuppression, and comorbidities. Noteworthy, among patients with diabetes, calprotectin showed an increase in performance, while those of C-reactive protein (CRP) and procalcitonin (PCT) both decreased.

Calprotectin was able to identify septic patients and predict 30-days mortality. Higher calprotectin concentrations were observed in septic patients than in those with non-septic bacterial infections, with the latter showing higher concentrations than patients without any infection. This separation was more pronounced for calprotectin than for PCT and CRP.




Improved patient management at the emergency department

In conclusion, this trial showed high accuracy of circulating calprotectin for all of the clinically relevant endpoints across key subpopulations;

  • Detection of bacterial infection
  • Prediction of sepsis and mortality

The authors concluded that calprotectin has the potential to complement the current diagnostic repertoire for patients with acute bacterial infections and sepsis for improved diagnosis and treatment decisions.

Preliminary results presented at ECCMID 2023

Dr. Wolfgang Bauer, PI of the trial has presented and discussed preliminary results from the study already at ECCMID 2023, you can watch the recording here:




GCAL® - a plasma and serum calprotectin assay

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 Particle-Enhanced Turbidimetric Immunoassay (PETIA) that can be applied on a wide range of automated clinical chemistry analysers. Specifically using avian antibodies in this test, results in the distinct benefit avoiding common interference (namely rheumatoid factor and HAMA antibodies).

GCAL® is the first available (since 2019) turbidimetric assay for circulating calprotectin. It is CE-marked and IVDR certified, in addition to other regional registrations.

All kit components are ready-to-use with calibrator and dedicated controls. Additionally, the reagent kit is available in two different sizes, catering to the diverse needs of laboratories, from smaller laboratories to high-volume routine users.

blood calprotectin


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