Procalcitonin behaves as a fast responding acute phase protein in vivo andin vitro

Citation
Mwn. Nijsten et al., Procalcitonin behaves as a fast responding acute phase protein in vivo andin vitro, CRIT CARE M, 28(2), 2000, pp. 458-461
Citations number
18
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
CRITICAL CARE MEDICINE
ISSN journal
00903493 → ACNP
Volume
28
Issue
2
Year of publication
2000
Pages
458 - 461
Database
ISI
SICI code
0090-3493(200002)28:2<458:PBAAFR>2.0.ZU;2-R
Abstract
Objectives: Procalcitonin (PCT) is a 13 kD protein of which plasma concentr ations are strongly increased in inflammatory states, PCT concentrations ar e claimed to have a more powerful discriminatory value for bacterial infect ion than the acute phase proteins serum amyloid A (SAA) or C-reactive prote in (CRP), The source of production and its mechanism of induction are unkno wn, We investigated the inducibility of PCT both in vivo and in vitro and c ompared the behavior of PCT with those of SAA and CRP, Design: A prospective descriptive patient sample study and a controlled liv er tissue culture study. Setting: A university hospital, Patients: Cancer patients who were treated with human tumor necrosis factor -alpha (rhTNF-alpha; 5 patients) or interleukin-6 (rhIL-6; 7 patients), Measurements and Main Results: Serial serum samples were collected for anal ysis of concentrations of PCT, SAA, and GRP, In the TNF-alpha group, freque nt sampling was performed on the first day to allow analysis of initial res ponses, In a human liver slice model, the release of PCT, SAA, and CRP was measured on induction with rhTNF-alpha and rhIL-6 for 24 hrs, We found that PCT displayed acute phase reactant behavior in vivo after administration o f both rhTNF-alpha and rhIL-6. after rhTNF-alpha-administration, PCT reache d half-maximal concentrations within 8 hrs, 12 hrs earlier than either SAA or GRP did. PCT, SAA, and CRP were produced in detectable quantities by liv er tissue in vitro, PCT production by liver slices was enhanced after stimu lation with rhTNF-alpha or rhIL-6; SAA and CRP concentrations were elevated after stimulation with rhTNF-alpha. Conclusions: We found that PCT and acute phase proteins such as CRP are ind uced by similar pathways, The liver appears to be a major source of PCT pro duction, Thus, PCT may be considered an acute phase protein. The different kinetics of PCT, rather than a fundamentally different afferent pathway, ma y explain its putative diagnostic potential to discriminate bacterial infec tion from other causes of inflammation.