Andreas Scherr1, Rolf Graf2, Martha Bain2, Mirjam Christ-Crain3, Beat Müller4, Michael Tamm1, Daiana Stolz5. 1. Clinic of Pulmonary Medicine and Respiratory Cell Research, Diabetes and Clinical Nutrition, University Hospital, Basel. 2. Pancreatitis Research Laboratory, University Hospital Zurich, Zurich. 3. Clinic of Endocrinology, Diabetes and Clinical Nutrition, University Hospital, Basel. 4. Medical University Clinic, Kantonsspital Aarau AG, Aarau, Switzerland. 5. Clinic of Pulmonary Medicine and Respiratory Cell Research, Diabetes and Clinical Nutrition, University Hospital, Basel. Electronic address: dstolz@uhbs.ch.
Abstract
BACKGROUND: Pancreatic stone protein/regenerating protein (PSP/reg) serum levels are supposed to be increased in bacterial inflammation. PSP/reg levels also might be useful, therefore, as a predictor of bacterial infection in COPD. METHODS: Two hundred consecutive patients presenting to the ED due to acute exacerbation of COPD were prospectively assessed. Patients were evaluated based on clinical, laboratory, and lung functional parameters at admission (exacerbation) and after short-term follow-up (14-21 days). PSP/reg serum values were measured by a newly developed enzyme-linked immunosorbent assay. RESULTS: PSP/reg levels were elevated in subjects with COPD exacerbation (23.8 ng/mL; 95% CI, 17.1-32.7) when compared with those with stable disease (19.1 ng/mL; 95% CI, 14.1-30.4; P 5 .03) and healthy control subjects (14.0 ng/mL; 95% CI , 12.0-19.0; P , .01). Higher PSP/reg values were observed in exacerbations with positive sputum bacteriology compared with those with negative sputum bacteriology (26.1 ng/mL [95% CI, 19.2-38.1] vs 20.8 ng/mL [95% CI , 15.6-27.2]; P , .01). Multivariate regression analysis revealed PSP/reg level as an independent predictor of positive sputum bacteriology. A combination of a PSP/reg cutoff value of . 33.9 ng/mL and presence of discolored sputum had a specificity of 97% to identify patients with pathogenic bacteria on sputum culture. In contrast, PSP/reg levels , 18.4 ng/mL and nonpurulent sputum ruled out positive bacterial sputum culture (sensitivity, 92%). In survival analysis, high PSP/reg levels at hospital admission were associated with increased 2-year mortality. CONCLUSIONS: Serum PSP/reg level might represent a promising new biomarker to identify bacterial etiology of COPD exacerbation.
BACKGROUND:Pancreatic stone protein/regenerating protein (PSP/reg) serum levels are supposed to be increased in bacterial inflammation. PSP/reg levels also might be useful, therefore, as a predictor of bacterial infection in COPD. METHODS: Two hundred consecutive patients presenting to the ED due to acute exacerbation of COPD were prospectively assessed. Patients were evaluated based on clinical, laboratory, and lung functional parameters at admission (exacerbation) and after short-term follow-up (14-21 days). PSP/reg serum values were measured by a newly developed enzyme-linked immunosorbent assay. RESULTS:PSP/reg levels were elevated in subjects with COPD exacerbation (23.8 ng/mL; 95% CI, 17.1-32.7) when compared with those with stable disease (19.1 ng/mL; 95% CI, 14.1-30.4; P 5 .03) and healthy control subjects (14.0 ng/mL; 95% CI , 12.0-19.0; P , .01). Higher PSP/reg values were observed in exacerbations with positive sputum bacteriology compared with those with negative sputum bacteriology (26.1 ng/mL [95% CI, 19.2-38.1] vs 20.8 ng/mL [95% CI , 15.6-27.2]; P , .01). Multivariate regression analysis revealed PSP/reg level as an independent predictor of positive sputum bacteriology. A combination of a PSP/reg cutoff value of . 33.9 ng/mL and presence of discolored sputum had a specificity of 97% to identify patients with pathogenic bacteria on sputum culture. In contrast, PSP/reg levels , 18.4 ng/mL and nonpurulent sputum ruled out positive bacterial sputum culture (sensitivity, 92%). In survival analysis, high PSP/reg levels at hospital admission were associated with increased 2-year mortality. CONCLUSIONS: Serum PSP/reg level might represent a promising new biomarker to identify bacterial etiology of COPD exacerbation.
Authors: Oliver Maximilian Fisher; Christian Eugen Oberkofler; Dimitri Aristotle Raptis; Christopher Soll; Markus Béchir; Marc Schiesser; Rolf Graf Journal: BMJ Open Date: 2014-03-06 Impact factor: 2.692
Authors: Luregn J Schlapbach; Eric Giannoni; Sven Wellmann; Martin Stocker; Roland A Ammann; Rolf Graf Journal: BMC Anesthesiol Date: 2015-11-20 Impact factor: 2.217