Circulating eNAMPT as a biomarker in the critically ill: acute pancreatitis, sepsis, trauma, and acute respiratory distress syndrome

• Published in: BMC anesthesiology Vol. 22; no. 1; p. 182
• Main Authors: Bime, Christian, Casanova, Nancy G, Camp, Sara M, Oita, Radu C, Ndukum, Juliet, Hernon, Vivian Reyes, Oh, Dong Kyu, Li, Yansong, Greer, Phil J, Whitcomb, David C, Papachristou, Georgios I, Garcia, Joe G N
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.06.2022; BioMed Central; BMC
• Subjects: Accuracy; Acute Disease; Acute respiratory distress syndrome; Analysis; ARDS; Biomarkers; Confidence intervals; COVID-19; Critical Illness; Cytokines; Diagnosis; eNAMPT; Enzymes; Ethylenediaminetetraacetic acid; Humans; Infection; Innate immunity; Medical research; Medicine, Experimental; Mortality; NAD; NAMPT; NF-κB protein; Niacinamide; Nicotinamide phosphoribosyltransferase; Pancreatitis; Pancreatitis - diagnosis; Patients; Phosphoribosyltransferase; Physiological aspects; Plasma; Protein turnover; Proteins; Respiratory distress syndrome; Respiratory Distress Syndrome - diagnosis; Sepsis; Sepsis - diagnosis; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; TLR4 protein; Toll-like receptors; Trauma; United Kingdom; South Korea; Taiwan; United States > US; Biomarker; NAMPT; Pancreatitis; Sepsis; eNAMPT; Trauma; ARDS
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-022-01718-1

Nicotinamide phosphoribosyltransferase (NAMPT) exhibits dual functionality - as an intracellular enzyme regulating nicotinamide adenine dinucleotide metabolism and as an extracellular secreted protein (eNAMPT) to function as a cytokine regulator of innate immunity via binding to Toll-Like receptor 4 and NF-κB activation. In limited preclinical and clinical studies, eNAMPT was implicated in the pathobiology of acute respiratory distress syndrome (ARDS) suggesting that eNAMPT could potentially serve as a diagnostic and prognostic biomarker. We investigated the feasibility of circulating eNAMPT levels to serve as a biomarker in an expanded cohort of patients with ARDS and ARDS-predisposing conditions that included acute pancreatitis, sepsis, and trauma with comparisons to controls. A total of 671 patients and 179 healthy controls were included in two independent cohorts. Plasma and serum eNAMPT levels were quantified using one of two complementary Enzyme-linked Immunosorbent Assays. After log base 2 variance stabilizing transformation of plasma/serum eNAMPT measurements, differences between healthy controls and each disease cohort were compared using linear regression or a generalized estimating equation (GEE) model where applicable. Complementary analyses included sensitivity, specificity, positive predictive values, negative predictive values, and the area under the receiver operating curve. Compared to controls, circulating eNAMPT levels were significantly elevated in subjects with acute pancreatitis, sepsis, trauma, and ARDS (all p < 0.01). In the acute pancreatitis cohort, circulating eNAMPT levels positively correlated with disease severity (p < 0.01). Circulating eNAMPT levels are novel biomarker in the critically ill with acute pancreatitis, sepsis, trauma, and/or ARDS with the potential to reflect disease severity.