Presepsin: A promising novel biomarker for the detection of sepsis

Öz

Sepsis, also defined as systemic inflammatory response syndrome, is defined as life-threatening multi-organ dysfunction. Early diagnosis in severe bacterial infections such as sepsis, is very important for the treatment and control of infectious diseases. However, the basic problem in recognizing bacterial infections is that the signs and symptoms often overlap with the clinical symptom of other inflammatory disorders. Although microbiological, biochemical and molecular methods have been widely used in the diagnosis of infections, they have some limitations in terms of sensitivity and specificity. Therefore, a gold standard indicator has not been revealed yet. The proposed biomarkers should be determined by cost-effective, fast, simple, reliable, specific and sensitive methods. Presepsin is a new protein also known as soluble cluster of differentiation 14 (sCD14-ST) subtype. It regulates the cellular and humoral immune system by directly interacting with T and B cells. It increases in response to bacterial infections and decreases after antibiotic therapy. Therefore, it is considered as an indicator of activation of the immune cell response against an invading pathogen. It is also suggested that it may be an early biomarker for sepsis. Presepsin has gained an important place in recent studies due to its stability in the general circulation and being a candidate biomarker of the first stage of systemic infection. The number of research articles and reviews about presepsin is increasing day by day in the literature. The purpose of this review is to evaluate the place and importance of presepsin measurement in sepsis, considering other sepsis biomarkers, which will provide great benefits to clinicians.

Anahtar Kelimeler

• Sepsis
• Presepsin
• sCD14-ST
• Biyomarker
• Infection

Presepsin: Sepsis tespiti için umut verici yeni bir biyobelirteç

Öz

Sistemik inflamatuar yanıt sendromu (SİYS) olarak da tanımlanan sepsis, hayatı tehdit eder boyutta seyreden çoklu organ fonksiyon bozukluğu olarak tanımlanmaktadır. Sepsis gibi ciddi bakteriyel enfeksiyonlarda erken teşhis, bulaşıcı hastalıkların tedavisi ve kontrolü için oldukça önem arz etmektedir. Ancak, bakteriyel enfeksiyonların tanınmasındaki ana problem, belirti ve semptomların klinik görünümünün sıklıkla diğer enflamatuvar bozukluklarla örtüşmesidir. Enfeksiyonların teşhisinde mikrobiyolojik, biyokimyasal ve moleküler yöntemler yaygın kullanılmasına rağmen, duyarlılık ve özgüllük açısından bazı sınırlamaları mevcuttur. Bu nedenle henüz altın standart bir belirteç ortaya konulamamıştır. Önerilen biyobelirteçlerin, uygun maliyetli, hızlı, basit, güvenilir, spesifik ve hassas yöntemlerle belirlenebilmesi gerekmektedir. Presepsin, çözünür farklılaşma kümesi 14 (SCD14-ST) alt tipi olarak da bilinen bir proteindir. T ve B hücreleri ile direkt etkileşime girerek hücresel ve humoral bağışıklık sistemini düzenler. Bakteriyel enfeksiyonlara yanıt olarak artmakta ve antibiyotik tedavisinden sonra azalmaktadır. Bu nedenle de, istilacı bir patojene karşı immün hücre yanıtının aktivasyonunun bir göstergesi olarak düşünülmektedir. Ayrıca sepsis için erken bir biyobelirteç olabileceği ileri sürülmektedir. Presepsin, genel dolaşımda kararlı olması ve sistemik enfeksiyonun ilk aşamasının aday bir biyobelirteç olması nedeniyle son yıllardaki çalışmalarda önemli yer edinmiştir. Literatürde presepsin hakkında araştırma makalesi ve derleme sayısı her geçen gün artmaktadır. Bu derlemenin amacı, klinisyenlere rehber olması açısından büyük yararlar sağlayacak presepsin ölçümünün sepsisdeki yeri ve önemi diğer sepsis biyobelirteçleri göz önüne alınarak değerlendirmektir.

Anahtar Kelimeler

• sepsis
• presepsin
• sCD14-ST
• Biyobelirteç
• Enfeksiyon

Kaynakça

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