Presepsin: A potential biomarker of PJI? A comparative analysis with known and new infection biomarkers

• Published in: International journal of immunopathology and pharmacology Vol. 31; p. 394632017749356
• Main Authors: Marazzi, Monica Gioia, Randelli, Filippo, Brioschi, Marco, Drago, Lorenzo, Romanò, Carlo Luca, Banfi, Giuseppe, Massaccesi, Luca, Crapanzano, Calogero, Morelli, Franca, Corsi Romanelli, Massimiliano Marco, Galliera, Emanuela
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2018; Sage Publications Ltd
• Subjects: Adolescent; Antigens, CD - metabolism; Antigens, Differentiation, Myelomonocytic - metabolism; Area Under Curve; Biomarkers; Biomarkers - metabolism; C-Reactive Protein - metabolism; Chemokine CCL2 - metabolism; Female; Humans; Inflammation - metabolism; Interleukin-6 - metabolism; Lipopolysaccharide Receptors - metabolism; Male; Matrix Metalloproteinase 9 - metabolism; Original; Osteopontin - metabolism; Peptide Fragments - metabolism; Prognosis; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - metabolism; Prosthesis-Related Infections - pathology; Receptors, Cell Surface - metabolism; ROC Curve; Sepsis - metabolism; Toll-Like Receptor 2 - metabolism; Toll-like receptors; Triggering Receptor Expressed on Myeloid Cells-1 - metabolism; presepsin; diagnosis; prognosis; serum biomarker; post-operative periprosthetic joint infection
• ISSN: 2058-7384; 0394-6320; 2058-7384
• DOI: 10.1177/0394632017749356

There is still no “gold standard” for the diagnosis and prognosis of post-operative periprosthetic joint infection (PJI). Among serum biomarkers, an emerging molecule is presepsin, the soluble fraction of CD14, recently described in other settings as a powerful diagnostic tool to detect sepsis at different degrees of severity. The aim of this study was to investigate the diagnostic and prognostic value of presepsin in PJI. A total of 30 patients with PJI and 30 patients without PJI were enrolled. Presepsin, C-reactive protein (CRP), serum interleukin (IL)-6, triggering receptor expressed on myeloid cells 1 (TREM-1), CCL2, matrix metalloproteinase 9 (MMP-9), CD163, osteopontin (OPN), and toll-like receptor 2 (TLR2) were measured at different times after surgery. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker. Presepsin showed greater diagnostic value than CRP and IL-6; CD163, TREM-1, and MMP-9 had very low diagnostic potential. Presepsin, OPN, CCL2, suPAR, and TLR2 all decreased significantly with increasing time of recovery after surgery in PJI patients. Presepsin can be considered a useful tool for the diagnosis and clinical monitoring of PJI and can be backed by a panel of new inflammatory markers involved in monocyte-/macrophage-mediated inflammatory responses, such as OPN, CCL2, TLR2, and suPAR.