Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2016; 22(41): 9172-9185
Published online Nov 7, 2016. doi: 10.3748/wjg.v22.i41.9172
Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis
Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Tamas Dinya, Andrea Sumegi, Peter Antal-Szalmas
Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, Hungary
David Tornai, Peter Antal-Szalmas, Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine Debrecen, H-4032 Debrecen, Hungary
Tamas Dinya, Institute of Surgery, University of Debrecen, Faculty of Medicine, H-4032 Debrecen, Hungary
Andrea Sumegi, Vascular Biology, Thrombosis and Haemostasis Research Group, Hungarian Academy of Sciences, H-4032 Debrecen, Hungary
Author contributions: Papp M, Tornai I and Antal-Szamas P designed the study; Tornai T, Tornai D, Vitalis Z, Dinya T and Sumegi A performed research; Papp M, Tornai T and Antal-Szalmas P analyzed data; Papp M, Tornai T and Antal-Szalmas P wrote the manuscript; Papp M and Tornai T contributed equally to the work and both should be considered as first authors.
Supported by János Bólyai Research Scholarship of Hungarian Academy of Sciences, No. BO/00426/11; University of Debrecen and Research Grant of National Research, No. RH/885/2013; Development and Innovation Office, No. K115818/2015/1.
Institutional review board statement: The study was reviewed and approved by the Hungarian National Review Board and the Institutional Review Board of the University of Debrecen.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Maria Papp, MD, PhD, Department of Internal Medicine, Division of Gastroenterology, University of Debrecen, Faculty of Medicine, Nagyerdei krt. 98, H-4032 Debrecen, Hungary. papp.maria@med.unideb.hu
Telephone: +36-52-255152 Fax: +36-52-255152
Received: June 28, 2016
Peer-review started: June 29, 2016
First decision: August 8, 2016
Revised: August 26, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: November 7, 2016
Processing time: 130 Days and 21.2 Hours
Core Tip

Core tip: C-reactive protein (CRP) and procalcitonin (PCT) are broadly used in clinical practice to aid early diagnosis of bacterial infections, but they have limitations in cirrhosis. Additional biomarkers with enhanced accuracy are highly needed. Presepsin is a novel biomarker of infection and sepsis, but has not been assessed in cirrhosis so far. In the present study we evaluated the diagnostic and prognostic performance of presepsin in cirrhosis-associated infections in comparison with classic acute phase proteins. Presepsin measurement enhanced diagnostic utility of CRP and reflected the severity of infections more accurately, with a similar efficacy as PCT. Advanced disease stage and renal failure limited the diagnostic accuracy. The increase in PCT level but not in presepsin concentration was an independent predictor of short-term mortality during infectious episodes.