Plasma calprotectin - a promising biomarker

08. Aug 2019 | 4 min read

Plasma calprotectin - a promising biomarker

 

Gentian hosted the Educational Workshop “Plasma Calprotectin: a promising early biomarker for diagnosis of bacterial infections and sepsis” at the EuroMedLab 2019 conference and exhibition.

We invited two experts in the field of bacterial infections and sepsis to present their research and clinical experience:

DIAGNOSIS OF SEVERE INFECTIONS AND SEPSIS: CHALLENGES WITH CURRENT BIOMARKERS
By Jordi Rello, MD, PhD (Spain)

CALPROTECTIN AS A RISK MARKER IN EMERGENCY DEPARTMENT PATIENTS WITH ACUTE DYSPNEA
By Toralph Ruge, MD, PhD (Sweden).

Please note that Dr Ruge was unable to attend EuroMedLab so his work was presented by Aleksandra Havelka from Gentian

 

Calprotectin and bacterial infections

Early diagnosis of bacterial infections will add information about both diagnosis and risk stratification, and can therefore improve the patient outcome. The ability to predict and detect an infection as early as possible can:

  • reduce morbidity and mortality
  • support the therapeutic decision making
  • differentiate between SIRS and sepsis

Calprotectin is a protein that is released upon activation of neutrophils, as a part of the early response to bacterial infection [1]. Calprotectin monitoring can therefore support better treatment efficiency due to the short half-life of calprotectin in serum and plasma (5 hours) [2].

 

calprotectin-web-web-ready

 

Biomarkers’ role in diagnosis of severe infections and sepsis

The rapidly growing problem with antibiotic resistance stresses the need for more specific and restrictive use of antibiotics. Biomarkers that can distinguish between bacterial infections and other causes of systemic inflammation at an early stage can help reduce the use of antibiotics.

Both Dr. Jordi and Dr. Rude discussed calprotectin and other biomarkers’ role in diagnosis of severe infections and sepsis in their presentations. The two doctors refer to studies and results that support the ability of calprotectin to discriminate patients with acute infections from patients with other states of inflammatory responses. This includes patients with heart failure, chronic obstructive pulmonary disease and asthma in the emergency department setting. An early diagnosis of sepsis, and hence an early onset of the appropriate therapy is vital for the patient outcome [3, 4].

 

calprotectin-chemical-analyser2-web-ready

 

Calprotectin:

  • is an independent predictor of 28-day mortality in septic patients [5]
  • is a promising/capable biomarker in early diagnosis and risk stratification [5]
  • is a promising biomarker in evaluation of prognosis in septic patients [5]
  • is an accurate marker of sepsis in very low birth weight new-borns [6]
  • has significant diagnostic accuracy for the bacterial etiology of sepsis [7]

 

References:

[1] Voganatsi A, Panyutich A, Miyasaki KT, Murthy RK. Mechanism of extracellular release of human neutrophil calprotectin complex. J. Leukoc. Biol. 70 (1), 130 –134 (2001).

[2] Fagerhol M K, Nielsen H G, Vetlesen A, Sandvik K, Lyberg T. Increase in plasma calprotectin during long‐distance running. Scand J Clin Lab Invest 200565211–220.

[3] Kumar A, Roberts D, Wood KE et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit. Care Med. 34(6), 1589 –1596 (2006).

[4] Dellinger RP, Levy MM, Rhodes A et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med.39(2), 165–228 (2013).

[5] Gao, S. et al (2015) Am J Emerg Med 33 1278–1282

[6] Terrin et al (2011), Clin Dev Immunol.; 2011:291085

[7] Bartáková E.et al (2019) Diagnostic Microbiol Infect Dis, 219-226

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