1. Academic Validation
  2. DcR3, a new biomarker for sepsis, correlates with infection severity and procalcitonin

DcR3, a new biomarker for sepsis, correlates with infection severity and procalcitonin

  • Oncotarget. 2017 Dec 28;9(13):10934-10944. doi: 10.18632/oncotarget.23736.
Liqin Gao 1 Bin Yang 1 Hairong Zhang 2 Qishui Ou 1 Yulan Lin 1 Mei Zhang 3 Zhenhuan Zhang 3 Sunghee Kim 4 Bing Wu 2 5 Zeng Wang 2 5 Lengxi Fu 2 5 Jingan Lin 2 5 Ruiqing Chen 2 5 Ruilong Lan 2 5 Junying Chen 2 5 Wei Chen 2 5 Long Chen 2 5 Hengshan Zhang 2 5 Deping Han 2 5 Jingrong Chen 2 5 Paul Okunieff 3 Jianhua Lin 2 5 Lurong Zhang 2 5
Affiliations

Affiliations

  • 1 Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
  • 2 Fujian Key Laboratory of Individualized Active Immunotherapy, Fuzhou 350005, China.
  • 3 Department of Radiation Oncology, University of Florida, Gainesville, Florida 32610, USA.
  • 4 BioPowerTech, Tuscaloosa, Alabama 35406, USA.
  • 5 Key Laboratory of Radiation Biology of Fujian Province Universities, Fuzhou 350005, China.
Abstract

Early diagnosis of sepsis is critical for successful treatment. The clinical value of DcR3 in early diagnosis of sepsis was determined in a dynamic follow-up study. Alterations in plasma levels of DcR3, PCT, CRP, and IL-6 were measured by ELISA and compared among patients with sepsis (n = 134), SIRS (n = 60) and normal adults (n = 50). Correlations and dynamic patterns among the biomarkers, APACHE II scores, clinical outcomes, and pathogens were also examined. Plasma DcR3 was significantly increased in sepsis compared to SIRS and normal adults (median 3.87 vs. 1.28 and 0.17 ng/ml). The elevated DcR3 could be detected in 97.60% sepsis patients 1-2 days prior to the result of blood culture reported. For diagnosis of sepsis, the sensitivity was 97.69% and specificity 98.04%; and for differential diagnosis of sepsis from SIRS, the sensitivity was 90.77% and specificity 98.40%. DcR3 level was positively correlated with severity of sepsis (rs = 0.82). In 41 patients who died of sepsis, DcR3 elevated as early as 1-2 days before blood culture and peaked on day 3 after blood culture performed. In 90% of sepsis patients, the dynamic alteration pattern of DcR3 was identical to that of PCT, while pattern of 10% patients differed in which clinical data was consistent with DcR3. In 13% sepsis patients, while PCT remained normal, DcR3 levels were at a high level. DcR3 levels had no difference among various pathogens infected. DcR3, a new biomarker, will aid in early diagnosis of sepsis and monitoring its outcome, especially when sepsis patients were PCT negative.

Keywords

clinical value; correlation with procalcitonin; early diagnosis; plasma DcR3; sepsis.

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