Research Article
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Pentraxin-3 in central nervous system infections: A promising but limited biomarker?

Year 2025, Volume: 42 Issue: 4, 388 - 393, 31.12.2025

Abstract

Central nervous system (CNS) infections lead to high morbidity and mortalitty rates, so there is a need for rapid and reliable biomarkers in diagnosis. The aim of this study was to determine the diagnostic value of Pentraxin-3 (PTX3) levels in CNS infections and to compare these with classic parameters. The study included 42 adult patients diagnosed with CNS infection between July 2020 and August 2021. The cerebral spinal fluid (CSF) and serum PTX3 levels were measured with the ELISA method. The findings were compared with clinical and laboratory parameters. The diagnostic performance was evaluated with ROC curve analysis. Bacterial meningitis was diagnosed in 39.0% of the patients, viral encephalitis in 51.2%, tuberculous meningitis in 7.3%, and fungal meningitis in 2.4%. The mortality rate was determined to be 43.9%. The CSF PTX3 levels were found to be higher in the bacterial cases, but with no significant difference between the serum and CSF PTX3 levels (p=0.327). A negative correlation was determined between CSF PTX3 and the Glasgow Coma Score, and a positive correlation between CSF PTX3 and the CSF protein level. In the ROC analyses, the strongest parameters for differentiation of bacterial and aseptic meningitis were seen to be CSF cell count (AUC: 0.888) and PMN percentage (AUC:0.882, while CSF PTX3 (AUC:0.586) and serum PTX3 (AUC:0.561) had the lowest differentiating power. PTX3 can be measured in CNS infections and higher levels are seen in bacterial meningitis cases. However, according to the ROC analysis results the diagnostic power is limited and these parameters lag behind classic CSF parameters. Therefore, PTX3 alone is not sufficient, but when combined with other biomarkers it can contribute to the clinical diagnostic process. The specific contribution of this study is that by evaluating both CSF and serum PTX3 levels simultaneously a relationship was determined between local and systemic inflammation.

Ethical Statement

This study was supported by Hatay Mustafa Kemal University Scientific Research Project Committee (Project number: 20.U.016).

Supporting Institution

Hatay Mustafa Kemal University Scientific Research Project Committee

Project Number

This study was conducted with the permission of Hatay Mustafa Kemal University Faculty of Medicine Clinical Research Ethics Committee numbered 2020/93.

References

  • Brindle HE, Choisy M, Christley R, et al. The global burden of central nervous system infections: a modelling study. Front Public Health. 2024;12:1371502. doi:10.3389/fpubh.2024.1371502
  • van Zeggeren IE, ter Horst L, Heijst H, Teunissen CE, van de Beek D, Brouwer MC. Neurofilament light chain in central nervous system infections: a prospective study of diagnostic accuracy. Sci Rep. 2022;12(1):14140. doi:10.1038/s41598-022-18450-9
  • Giuliano S, Flammini S, Giacobbe DR, et al. Role of procalcitonin and C-reactive protein in patients with bacterial meningitis. Eur J Clin Microbiol Infect Dis. 2022;41(3):387-94. doi:10.1007/s10096-021-04358-8
  • Bottazzi B, Inforzato A, Messa M, et al. The pentraxins PTX3 and SAP in innate immunity, regulation of inflammation and tissue remodelling. J Hepatol. 2016;64(6):1416-27. doi:10.1016/j.jhep.2016.02.029
  • Garlanda C, Bottazzi B, Bastone A, Mantovani A. Pentraxins at the crossroads between innate immunity, inflammation, matrix deposition, and female fertility. Annu Rev Immunol. 2005;23:337-66. doi:10.1146/annurev.immunol.23.021704.115756
  • Bonacina S, Barbieri SS, Cutuli L, et al. Pentraxin 3 in cardiovascular and neuroinflammatory disorders. Front Immunol. 2022;13:841095. doi:10.3389/fimmu.2022.841095
  • Zatta M, Di Pietro A, D'Abramo A, et al. Cerebrospinal fluid pentraxin 3 in patients with meningitis: diagnostic and prognostic significance. Eur J Clin Microbiol Infect Dis. 2020;39(4):665-70. doi:10.1007/s10096-019-03759-7
  • El-Kady H, Mostafa MG, Hassan R, et al. Cerebrospinal fluid pentraxin 3 as a biomarker for bacterial meningitis in children. BMC Pediatr. 2025;25(1):7. doi:10.1186/s12887-024-05065-1
  • Porte R, Davoudian S, Asgari F, et al. The long pentraxin PTX3 as a key component of humoral innate immunity and a candidate diagnostic/prognostic biomarker in infectious and inflammatory diseases. Front Immunol. 2019;10:794. doi:10.3389/fimmu.2019.00794
  • Thomsen MM, Munthe-Fog L, Garred P, et al. Pentraxin 3 levels in cerebrospinal fluid as a diagnostic marker of bacterial meningitis. PLoS One. 2023;18(3):e0282004. doi:10.1371/journal.pone.0282004
  • Hamed GM, Megahed NA, Abdelhakeem G, et al. Plasma pentraxin 3 in patients with sepsis: relationship with severity and outcome. BMC Infect Dis. 2017;17:554. doi:10.1186/s12879-017-2663-0.

Year 2025, Volume: 42 Issue: 4, 388 - 393, 31.12.2025

Abstract

Project Number

This study was conducted with the permission of Hatay Mustafa Kemal University Faculty of Medicine Clinical Research Ethics Committee numbered 2020/93.

References

  • Brindle HE, Choisy M, Christley R, et al. The global burden of central nervous system infections: a modelling study. Front Public Health. 2024;12:1371502. doi:10.3389/fpubh.2024.1371502
  • van Zeggeren IE, ter Horst L, Heijst H, Teunissen CE, van de Beek D, Brouwer MC. Neurofilament light chain in central nervous system infections: a prospective study of diagnostic accuracy. Sci Rep. 2022;12(1):14140. doi:10.1038/s41598-022-18450-9
  • Giuliano S, Flammini S, Giacobbe DR, et al. Role of procalcitonin and C-reactive protein in patients with bacterial meningitis. Eur J Clin Microbiol Infect Dis. 2022;41(3):387-94. doi:10.1007/s10096-021-04358-8
  • Bottazzi B, Inforzato A, Messa M, et al. The pentraxins PTX3 and SAP in innate immunity, regulation of inflammation and tissue remodelling. J Hepatol. 2016;64(6):1416-27. doi:10.1016/j.jhep.2016.02.029
  • Garlanda C, Bottazzi B, Bastone A, Mantovani A. Pentraxins at the crossroads between innate immunity, inflammation, matrix deposition, and female fertility. Annu Rev Immunol. 2005;23:337-66. doi:10.1146/annurev.immunol.23.021704.115756
  • Bonacina S, Barbieri SS, Cutuli L, et al. Pentraxin 3 in cardiovascular and neuroinflammatory disorders. Front Immunol. 2022;13:841095. doi:10.3389/fimmu.2022.841095
  • Zatta M, Di Pietro A, D'Abramo A, et al. Cerebrospinal fluid pentraxin 3 in patients with meningitis: diagnostic and prognostic significance. Eur J Clin Microbiol Infect Dis. 2020;39(4):665-70. doi:10.1007/s10096-019-03759-7
  • El-Kady H, Mostafa MG, Hassan R, et al. Cerebrospinal fluid pentraxin 3 as a biomarker for bacterial meningitis in children. BMC Pediatr. 2025;25(1):7. doi:10.1186/s12887-024-05065-1
  • Porte R, Davoudian S, Asgari F, et al. The long pentraxin PTX3 as a key component of humoral innate immunity and a candidate diagnostic/prognostic biomarker in infectious and inflammatory diseases. Front Immunol. 2019;10:794. doi:10.3389/fimmu.2019.00794
  • Thomsen MM, Munthe-Fog L, Garred P, et al. Pentraxin 3 levels in cerebrospinal fluid as a diagnostic marker of bacterial meningitis. PLoS One. 2023;18(3):e0282004. doi:10.1371/journal.pone.0282004
  • Hamed GM, Megahed NA, Abdelhakeem G, et al. Plasma pentraxin 3 in patients with sepsis: relationship with severity and outcome. BMC Infect Dis. 2017;17:554. doi:10.1186/s12879-017-2663-0.
There are 11 citations in total.

Details

Primary Language English
Subjects Infectious Diseases
Journal Section Research Article
Authors

Berfin Çirkin Doruk 0000-0002-5370-4197

Yusuf Önlen 0000-0002-8163-1386

Serdar Doğan 0000-0001-6854-2197

Tayibe Bal 0000-0002-5315-122X

Project Number This study was conducted with the permission of Hatay Mustafa Kemal University Faculty of Medicine Clinical Research Ethics Committee numbered 2020/93.
Submission Date May 15, 2025
Acceptance Date December 16, 2025
Publication Date December 31, 2025
Published in Issue Year 2025 Volume: 42 Issue: 4

Cite

APA Çirkin Doruk, B., Önlen, Y., Doğan, S., Bal, T. (2025). Pentraxin-3 in central nervous system infections: A promising but limited biomarker? Deneysel Ve Klinik Tıp Dergisi, 42(4), 388-393.
AMA Çirkin Doruk B, Önlen Y, Doğan S, Bal T. Pentraxin-3 in central nervous system infections: A promising but limited biomarker? J. Exp. Clin. Med. December 2025;42(4):388-393.
Chicago Çirkin Doruk, Berfin, Yusuf Önlen, Serdar Doğan, and Tayibe Bal. “Pentraxin-3 in Central Nervous System Infections: A Promising But Limited Biomarker?”. Deneysel Ve Klinik Tıp Dergisi 42, no. 4 (December 2025): 388-93.
EndNote Çirkin Doruk B, Önlen Y, Doğan S, Bal T (December 1, 2025) Pentraxin-3 in central nervous system infections: A promising but limited biomarker? Deneysel ve Klinik Tıp Dergisi 42 4 388–393.
IEEE B. Çirkin Doruk, Y. Önlen, S. Doğan, and T. Bal, “Pentraxin-3 in central nervous system infections: A promising but limited biomarker?”, J. Exp. Clin. Med., vol. 42, no. 4, pp. 388–393, 2025.
ISNAD Çirkin Doruk, Berfin et al. “Pentraxin-3 in Central Nervous System Infections: A Promising But Limited Biomarker?”. Deneysel ve Klinik Tıp Dergisi 42/4 (December2025), 388-393.
JAMA Çirkin Doruk B, Önlen Y, Doğan S, Bal T. Pentraxin-3 in central nervous system infections: A promising but limited biomarker? J. Exp. Clin. Med. 2025;42:388–393.
MLA Çirkin Doruk, Berfin et al. “Pentraxin-3 in Central Nervous System Infections: A Promising But Limited Biomarker?”. Deneysel Ve Klinik Tıp Dergisi, vol. 42, no. 4, 2025, pp. 388-93.
Vancouver Çirkin Doruk B, Önlen Y, Doğan S, Bal T. Pentraxin-3 in central nervous system infections: A promising but limited biomarker? J. Exp. Clin. Med. 2025;42(4):388-93.