DOCSLIB.ORG

Circulating Soluble Urokinase Plasminogen Activator Receptor Is

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Circulating Soluble Urokinase Plasminogen Activator Receptor Is Koch et al. Critical Care 2011, 15:R63 http://ccforum.com/content/15/1/R63 RESEARCH Open Access Circulating soluble urokinase plasminogen activator receptor is stably elevated during the first week of treatment in the intensive care unit and predicts mortality in critically ill patients Alexander Koch1, Sebastian Voigt1, Carsten Kruschinski2, Edouard Sanson1, Hanna Dückers1, Andreas Horn1, Eray Yagmur3, Henning Zimmermann1, Christian Trautwein1 and Frank Tacke1* Abstract Introduction: suPAR is the soluble form of the urokinase plasminogen activator receptor (uPAR), which is expressed in various immunologically active cells. High suPAR serum concentrations are suggested to reflect the activation of the immune system in circumstances of inflammation and infection, and have been associated with increased mortality in different populations of non-intensive care patients. In this study we sequentially analyzed suPAR serum concentrations within the first week of intensive care in a large cohort of well characterized intensive care unit (ICU) patients, in order to investigate potential regulatory mechanisms and evaluate the prognostic significance in critically ill patients. Methods: A total of 273 patients (197 with sepsis, 76 without sepsis) were studied prospectively upon admission to the medical intensive care unit (ICU), on Day 3 and Day 7, and compared to 43 healthy controls. Clinical data, various laboratory parameters as well as investigational inflammatory cytokine profiles were assessed. Patients were followed for approximately one year. Results: Upon admission to the ICU suPAR serum concentrations were elevated in critically ill patients as compared with healthy controls. In sepsis patients suPAR levels were higher than in non-sepsis patients (with or without systemic inflammatory response syndrome (SIRS)). During the first week after admission to the ICU serum suPAR concentrations remained stably elevated. suPAR serum concentrations measured upon admission were closely and independently correlated to various laboratory parameters, specifically biomarkers of inflammation (tumor necrosis factor (TNF), C-reactive protein (CRP)), hepatic and renal dysfunction. High suPAR levels at admission and at Day 3 were a strong independent predictor for both ICU and long-term mortality in critically ill patients. Conclusions: In sepsis and non-sepsis patients suPAR serum concentrations are increased upon admission to the ICU, likely reflecting the activation state of the immune system, and remain stably elevated in the initial course of treatment. Low suPAR levels are a positive predictor of ICU- and overall survival in critically ill patients, including sepsis and non-sepsis patients. Aside from its value as a promising new prognostic biomarker, both experimental and clinical studies are required in order to understand the specific effects and regulatory mechanisms of suPAR in SIRS and sepsis, and may reveal new therapeutic options. * Correspondence: [email protected] 1Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany Full list of author information is available at the end of the article © 2011 Koch et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Koch et al. Critical Care 2011, 15:R63 Page 2 of 14 http://ccforum.com/content/15/1/R63 Introduction female with a median age of 64 years; range 18 to The urokinase plasminogen activator receptor (uPAR) is 90 years) in our study who were admitted to the General expressed on different cell types including neutrophils, Internal Medicine ICU at the RWTH-University Hospital lymphocytes, monocytes, macrophages, certain cancer Aachen, Germany (Table 1). Written informed consent cells and vascular endothelial cells. uPAR and its ligand was obtained from the patient, his or her spouse or the urokinase plasminogen activator (uPA) are participants appointed legal guardian. Not included in this study were in numerous immunologic functions including migra- patients who were expected to have a short-term (< 72 h) tion, adhesion, angiogenesis, fibrinolysis and cell prolif- intensive care treatment due to post-interventional eration and have been found to promote tissue invasion observation or acute intoxication [12]. The medium in malignant diseases by converting plasminogen into length of stay at the ICU was 9 days (range 1 to 137 days) plasmin, resulting in degradation of extracellular matrix and medium length of stay in the hospital was 27 days [1-4]. Migration of inflammatory cells from the blood (range 2 to 151 days). stream into tissues is also an essential component of Patient data, clinical information and blood samples inflammation and immune response against infection, in were collected prospectively. The clinical course of which the uPAR/uPA system is directly involved [5]. patients was observed in a follow-up period by directly Through inflammatory stimulation uPAR is cleaved contacting the patients, the patients’ relatives or their from the cell surface by proteases to the soluble form of primary care physician. Patients who met the criteria the receptor, suPAR, which has been detected in blood, proposed by the American College of Chest Physicians urine and cerebro-spinal fluid [6-9]. Increased activation and the Society of Critical Care Medicine Consensus of the immune system caused by different types of infec- Conference Committee for severe sepsis and septic tions or various solid tumours, results in increased shock were categorized as sepsis patients, the others as suPAR concentrations in body fluids. Thereby serum non-sepsis patients [13]. suPAR levels are believed to mirror the degree of immu- As a control population we analyzed 43 healthy blood noactivation. Moreover, high suPAR serum concentra- donors (28 male, 15 female; median age 53, range 24 to tions have been found to predict mortality in patients 68 years) with normal values for blood counts, C-reactive with active tuberculosis and in healthy subjects [10]. In protein and liver enzymes. a recent study, high suPAR serum concentrations have been shown to indicate a poor outcome in patients with Characteristics of sepsis and non-sepsis patients systemic inflammatory response syndrome (SIRS) Among the 273 critically ill patients enrolled in this admitted to an emergency department and to a depart- study, 197 patients conformed to the criteria of bacterial ment of infectious diseases without an intensive-care sepsis (Table 1). Pneumonia was identified in the major- environment [11]. Yet, these findings have been ity of sepsis patients as the origin of infection (Table 2). regarded as possibly applicable only to patients with Non-sepsis patients were admitted to the ICU mainly community-acquired infections, which did not require due to cardiopulmonary diseases (myocardial infarction, intensive-treatment, and the validity for critically ill pulmonary embolism, and cardiac pulmonary edema), patients was questioned. decompensated liver cirrhosis or other critical condi- Thepresentstudywasconductedwithalargecohort tions and did not differ in age or sex from sepsis of well characterized critically ill patients in a medical patients. Sepsis patients were more often in need of ICU to provide information on suPAR serum concentra- mechanical ventilation in longer terms as compared to tions in different circumstances of critical disease, to the non-sepsis patients’ cohort (Table 1). In sepsis identify potential regulatory mechanisms of suPAR by patients significantly higher levels of routinely used bio- correlations with a wide number of markers of inflam- markers of inflammation (that is, C-reactive protein, mation, organ dysfunction and metabolism and to eluci- procalcitonin, white blood cell count) were found (Table 1, date the prognostic impact of suPAR in critically ill and data not shown). Both groups did not differ in Acute patients. Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) and Simpli- Materials and methods fied Acute Physiology Score (SAPS)2 score, vasopressor Study design and patient characteristics demand, or laboratory parameters indicating liver or renal The study protocol was approved by the local ethics dysfunction (data not shown). committee and conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki suPAR measurements (ethics committee of the University Hospital Aachen, Blood samples were collected upon admission to the ICU RWTH-University, Aachen, Germany, reference number (prior to therapeutic interventions) as well as in the morn- EK 150/06). We enrolled 273 patients (172 male, 101 ing of Day 3 and Day 7 after admission. After centrifugation Koch et al. Critical Care 2011, 15:R63 Page 3 of 14 http://ccforum.com/content/15/1/R63 Table 1 Baseline patient characteristics and suPAR serum concentrations Parameter All patients Sepsis Non-sepsis Number 273 197 76 Sex (male/female) 172/101 128/69 44/32 Age median (range) (years) 64 (18 to 90) 65 (20 to 90) 60 (18 to 85) APACHE-II score median (range) 17 (0 to 40) 18 (0 to 40) 15 (0 to 31) SOFA score median (range) 11 (0 to 17) 11 (2 to 17) 7 (0 to 16) SAPS2 score median (range) 44 (0 to 80) 44.5 (0 to 79) 41.5 (13 to 80) ICU days median (range) 9 (0 to 137) 12 ** (0 to 137)
Load more

Recommended publications
  • Treatmentupdate 223 Vol
    TreatmentUpdate 223 Vol. 29, No. 5 · December 2017 Available online at www.catie.ca/en/treatmentupdate Contents G. Canakinumab’s anti-cancer potential 10 I INFLAMMATION AND HIV H. Issues to consider with canakinumab 12 A. Exploring HIV and inflammation 2 I. Canakinumab in HIV reduces B. Inflammation in arteries vs. inflammation 13 lymph nodes 5 J. The potential of Ixolaris 15 C. Pitavastatin found to reduce levels of bad cholesterol and inflammation 6 K. Clinical trials in Canada to explore reducing inflammation in HIV 16 D. Inflammation-related illness among HIV-positive people 7 L. suPAR—an early warning signal 16 E. Why is there renewed interest in the antibody canakinumab? 8 F. Canakinumab—effect on reducing inflammation and heart attacks in the Cantos study 9 produced by 555 Richmond Street West, Suite 505 Box 1104 Toronto, Ontario M5V 3B1 Canada phone: 416.203.7122 toll-free: 1.800.263.1638 fax: 416.203.8284 www.catie.ca charitable registration number: 13225 8740 RR Page 2 TreatmentUpdate 223 — Vol. 29 No. 5 __________________________________________________________ I INFLAMMATION AND HIV Why is persistent immune activation and inflammation important? A. Exploring HIV and inflammation The activation of the immune system and inflammation are important responses used by Chronic HIV infection is associated with relatively the immune system to help control infections and high levels of inflammation and a growing body tumours. However, researchers are concerned that of evidence suggests that inflammation may prolonged immune activation and inflammation increase the risk for a range of health problems. could slowly degrade vital organ-systems in the body.
    [Show full text]
  • Utility of the Plasma Level of Supar in Monitoring Risk of Mortality During TB Treatment
    Utility of the Plasma Level of suPAR in Monitoring Risk of Mortality during TB Treatment Paulo Rabna1, Andreas Andersen1, Christian Wejse1,2,3, Ines Oliveira4, Victor Francisco Gomes1, Maya Bonde Haaland3, Peter Aaby1,5, Jesper Eugen-Olsen1* 1 Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau, 2 Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark, 3 Center of Global Health, School of Public Health, Aarhus University, Aarhus, Denmark, 4 Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark, 5 Bandim Health Project, Statens Serum Institute, Copenhagen, Denmark Abstract Objective: To investigate whether changes in the plasma level of soluble urokinase plasminogen activator receptor (suPAR) can be used to monitor tuberculosis (TB) treatment efficacy. Design: This prospective cohort study included 278 patients diagnosed with active pulmonary TB and followed throughout the 8-month treatment period. Results: Mortality during treatment was higher in the highest inclusion quartile of suPAR (23%) compared to the lowest three quartiles (7%), the risk ratio being 3.1 (95% CI 1.65–6.07). No association between early smear conversion and subsequent mortality or inclusion suPAR was observed. After 1 and 2 months of treatment, an increase in suPAR compared to at diagnosis was associated with a Mortality Rate Ratio (MRR) of 4.5 (95%CI: 1.45–14.1) and 2.1 (95%CI 0.62–6.82), respectively, for the remaining treatment period. Conclusions: The present study confirmed that elevated suPAR level at time of initiation of TB treatment is associated with increased risk of mortality. Furthermore, increased suPAR levels after one month of treatment was associated with increased risk of mortality during the remaining 7-month treatment period.
    [Show full text]
  • 1 Instructions for Use Suparnostic® Turbilatex Reagents
    1 Instructions for Use suPARnostic® TurbiLatex Reagents INTERPRETATION OF suPAR suPAR level Clinical decision soluble urokinase Plasminogen Activator Receptor <3 ng/mL Supports the decision of discharge. T005 The underlying health condition is good, and the prognosis for surviving is very high. suPARnostic® and the ViroGates A/S ViroGates logo are Banevaenget 13 3-6 ng/mL Some disease activity or co-morbidity is present. registered trademarks of Birkeroed 3460, Some readmissions and an elevated mortality are ViroGates A/S Denmark. Denmark expected after 6 months follow-up. ©2008 ViroGates. Tel: +45 2113 1336 www.virogates.com All rights reserved. >6 ng/mL Attention is needed. High risk of mortality. Further tests are needed to find the presence of severe disease. Table 1: Simplified suPAR clinical decision scheme (data from Danish hospital)3. Interpretation of results must be made considering the patient´s clinical history and results of other diagnostic tests. The decision to discharge This product is protected by one or more US, European, and/or foreign can, therefore, not be performed solely based on the patients suPAR patents. value. The T005 product is validated on the automated Roche Cobas c701/2 PRINCIPLES OF ASSAY PROCEDURE ® instrument (Cobas is a trademark of Roche), and this instruction for use The suPARnostic® TurbiLatex test is a turbidimetric immunoassay is dedicated for the Roche cobas c701/c702 biochemistry analyser. that quantitatively determines suPAR in human plasma samples. The first stage of testing is an incubation of human origin specimen (EDTA- Refer to the webpage http://www.virogates.com for instructions for use or Heparin plasma) with the R1 reagent.
    [Show full text]
  • Soluble Urokinase Plasminogen Activator Receptor Predicts
    1112 Diabetes Care Volume 42, June 2019 Viktor Rotbain Curovic,1 Simone Theilade,1 Soluble Urokinase Plasminogen Signe A. Winther,1 Nete Tofte,1 Jesper Eugen-Olsen,2 Frederik Persson,1 Activator Receptor Predicts Tine W. Hansen,1 Jørgen Jeppesen,3,4 and Cardiovascular Events, Kidney Peter Rossing1,4 Function Decline, and Mortality in Patients With Type 1 Diabetes Diabetes Care 2019;42:1112–1119 | https://doi.org/10.2337/dc18-1427 OBJECTIVE Soluble urokinase plasminogen activator receptor (suPAR) is an important in- flammatory biomarker implicated in endothelial and podocyte dysfunction. How- ever, suPAR’s predictive qualities for complications in type 1 diabetes have yet to be determined. We investigated the prognostic value of suPAR for the development of cardiovascularevents,declineinrenalfunction, andmortalityinpatientswith type1 diabetes. RESEARCH DESIGN AND METHODS We included 667 patients with type 1 diabetes with various degrees of albuminuria inaprospective study. End points were cardiovascular events (cardiovascular death, nonfatal acute myocardial infarction, nonfatal stroke, or coronary or peripheral arterial interventions), estimated glomerular filtration rate (eGFR) decline ‡30%, progressionfromlowertohigheralbuminuricstate,developmentofend-stagerenal disease (ESRD), and mortality. Follow-up was 5.2–6.2 years. Results were adjusted for known risk factors. Hazard ratios (HRs) are presented per doubling of suPAR with 95% CI. Relative integrated discrimination improvement (rIDI) was calculated. 1Steno Diabetes Center Copenhagen,
    [Show full text]
  • Of Body Inflammation for Maxillofacial Surgery Purpose-To Make
    applied sciences Article Index of Body Inflammation for Maxillofacial Surgery Purpose-to Make the Soluble Urokinase-Type Plasminogen Activator Receptor Serum Level Independent on Patient Age Marcin Kozakiewicz 1,*, Magdalena Trzci´nska-Kubik 1 and Rafał Nikodem Wlazeł 2 1 Department of Maxillofacial Surgery, Medical University of Lodz, 113 Zeromskiego˙ Str., 90-549 Lodz, Poland; [email protected] 2 Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, 251 Pomorska Str., 92-213 Lodz, Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-42-6393068 Featured Application: Inflammation is still a threat to patients of all age groups. Monitoring the infection is essential to control it. The soluble urokinase-type plasminogen activator receptor (suPAR) is a very sensitive marker. Maxillofacial surgery is one of the fields of medicine widely fighting against infections. The concentration of suPAR holds an independent information for risk stratification of morbidity and mortality in various acute and chronic diseases. The use of an ultra-sensitive measure of the development of inflammation and at the same time independent on the patient’s age would be clinically very beneficial. Abstract: Background: The serum suPAR level is affected in humans by it increases with age. Therefore it makes difficult interpretation and any comparison of age varied groups. The aim of this Citation: Kozakiewicz, M.; study is to find simple way to age independent presentation of suPAR serum level for maxillofacial Trzci´nska-Kubik,M.; Wlazeł, R.N. surgery purpose. Methods: In generally healthy patients from 15 to 59 y.o. suPAR level was tested Index of Body Inflammation for in serum before orthognathic or minor traumatologic procedures.
    [Show full text]
  • Predicts Microalbuminuria in Patients at Risk for Type 2 Diabetes Mellitus
    www.nature.com/scientificreports OPEN Soluble urokinase receptor (suPAR) predicts microalbuminuria in patients at risk for type 2 Received: 09 August 2016 Accepted: 08 December 2016 diabetes mellitus Published: 16 January 2017 Martina Guthoff1,2,3,*, Robert Wagner1,2,3,*, Elko Randrianarisoa1,2,3, Erifili Hatziagelaki4, Andreas Peter1,2,3, Hans-Ulrich Häring1,2,3, Andreas Fritsche1,2,3 & Nils Heyne1,2,3 Early identification of patients at risk of developing diabetic nephropathy is essential. Elevated serum concentrations of soluble urokinase receptor (suPAR) associate with diabetes mellitus and predict onset and loss of renal function in chronic kidney disease. We hypothesize, that suPAR may be an early risk indicator for diabetic nephropathy, preceding microalbuminuria. The relationship of baseline suPAR and incident microalbuminuria was assessed in a prospective long-term cohort of subjects at increased risk for type 2 diabetes (TULIP, n = 258). Association with albuminuria at later stages of disease was studied in a cross-sectional cohort with manifest type 2 diabetes (ICEPHA, n = 266). A higher baseline suPAR was associated with an increased risk of new-onset microalbuminuria in subjects at risk for type 2 diabetes (hazard ratio 5.3 (95% CI 1.1–25.2, p = 0.03) for the highest vs. lowest suPAR quartile). The proportion of subjects with prediabetes at the end of observation was higher in subjects with new-onset microalbuminuria. suPAR consistently correlated with albuminuria in a separate cohort with manifest type 2 diabetes. Elevated baseline suPAR concentrations independently associate with new-onset microalbuminuria in subjects at increased risk of developing type 2 diabetes.
    [Show full text]
  • Supar Level Is Associated with Myocardial Impairment Assessed
    174:6 S Theilade and others suPAR associated with 174:6 745–753 Clinical Study myocardial impairment suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease Simone Theilade1, Peter Rossing1,2,3, Jesper Eugen-Olsen4, Jan S Jensen3,5 and Magnus T Jensen1,5,6 1 2 3 Steno Diabetes Center, Gentofte, Denmark, Aarhus University, Aarhus, Denmark, University of Copenhagen, Correspondence 4 Copenhagen, Denmark, Clinical Research Center, Hvidovre Hospital, Hvidovre, Denmark, should be addressed 5 6 Department of Cardiology, Gentofte Hospital, Gentofte, Denmark and Department of Internal Medicine, to S Theilade Holbaek Sygehus, Holbaek, Denmark Email [email protected] Abstract Aim: Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. Methods: In an observational study on 318 patients with type 1 diabetes without known heart disease and European Journal European of Endocrinology with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates. Results: Patients were 55 ± 12 years (mean ± S.D.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58 ± 5%.
    [Show full text]
  • Soluble Urokinase Plasminogen Activator Receptor (Supar)
    University of Southern Denmark Soluble urokinase plasminogen activator receptor (suPAR) is a novel, independent predictive marker of myocardial infarction in HIV-1-infected patients a nested case-control study Rasmussen, L J H; Knudsen, A; Katzenstein, T L; Gerstoft, J; Obel, N; Rye Jørgensen, Niklas ; Kronborg, G; Benfield, T; Kjær, A; Eugen-Olsen, J; Lebech, A-M Published in: HIV Medicine DOI: 10.1111/hiv.12315 Publication date: 2016 Document version: Final published version Document license: CC BY-NC-ND Citation for pulished version (APA): Rasmussen, L. J. H., Knudsen, A., Katzenstein, T. L., Gerstoft, J., Obel, N., Rye Jørgensen, N., Kronborg, G., Benfield, T., Kjær, A., Eugen-Olsen, J., & Lebech, A-M. (2016). Soluble urokinase plasminogen activator receptor (suPAR) is a novel, independent predictive marker of myocardial infarction in HIV-1-infected patients: a nested case-control study. HIV Medicine, 17(5), 350–357 . https://doi.org/10.1111/hiv.12315 Go to publication entry in University of Southern Denmark's Research Portal Terms of use This work is brought to you by the University of Southern Denmark. Unless otherwise specified it has been shared according to the terms for self-archiving. If no other license is stated, these terms apply: • You may download this work for personal use only. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying this open access version If you believe that this document breaches copyright please contact us providing details and we will investigate your claim. Please direct all enquiries to [email protected] Download date: 23.
    [Show full text]
  • 10, Tumor Necrosis Factor -Alpha, Neopterin and Plasma Soluble Urokinase Plasminogen Activator Receptor Levels in the Patients with Pandemic H1N1 Influenza Infection
    Journal of Microbiology and Infectious Diseases / 2015; 5 (3): 119-124 JMID doi: 10.5799/ahinjs.02.2015.03.0189 RESEARCH ARTICLE Serum interleukin-6, interleukin -10, tumor necrosis factor -alpha, neopterin and plasma soluble urokinase plasminogen activator receptor levels in the patients with pandemic H1N1 influenza infection Hasan Irmak1, Mustafa Karahocağil2, Salih Cesur1, Yasemin Fidan3, Sema Özdamar3, Erdem Karabulut4, Hayrettin Akdeniz2, Ali Pekcan Demiröz1 1 Ankara Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Turkey 2 Van Yüzüncü Yıl University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Van, Turkey 3 Ankara Training and Research Hospital, Clinic of Biochemistry and Clinical Biochemistry, Ankara, Turkey 4 Hacettepe University, Faculty of Medicine, Department of Bioistatistics, Ankara, Turkey ABSTRACT Objective: This study aims to investigate the clinical importance of serum interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-alpha), neopterin, and plasma soluble urokinase plasminogen activator receptor (suPAR) levels in patients with pandemic H1N1 influenza infection and outpatients diagnosed with upper respiratory infections. Materials and Methods: Twenty-six inpatients with H1N1 infection confirmed by clinical findings and polymerase chain reaction (PCR) test 30 outpatients diagnosed with upper respiratory infections, and 24 healthy individuals without any complaints were included. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were compared between the patients groups and the 24 healthy controls. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were determined through the enzyme-linked immunosorbent assay (ELISA) as per manufacturer’s instruc- tions. Results: The median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 27.8 ng/ml, 9.29 ng/ml, 11.04 ng/ml, 8.82 ng/ml and 5.64 ng/ml, respectively in inpatients with H1N1.
    [Show full text]
  • Supar As a Marker of Infection in Acute Kidney Injury – a Prospective Observational Study Anna Hall1, Siobhan Crichton2, Matt Varrier3, Danielle E
    Hall et al. BMC Nephrology (2018)19:191 https://doi.org/10.1186/s12882-018-0990-6 RESEARCHARTICLE Open Access suPAR as a marker of infection in acute kidney injury – a prospective observational study Anna Hall1, Siobhan Crichton2, Matt Varrier3, Danielle E. Bear4 and Marlies Ostermann3,5* Abstract Background: Soluble urokinase-type plasminogen activator receptor (suPAR) has emerged as a new sepsis biomarker. It is not known whether suPAR has a role in critically ill patients with severe acute kidney injury (AKI). Methods: Our main aims were to describe serial serum suPAR concentrations in patients with severe AKI, to investigate a potential association between suPAR and C-reactive protein (CRP), and to compare suPAR and CRP as diagnostic markers of infection in patients with AKI. Between April 2013 – April 2014, we recruited adult patients (≥18 years) with AKI KDIGO stage 2/3 admitted to a multidisciplinary Intensive Care Unit (ICU) in a University Hospital in UK. Serial serum suPAR and CRP concentrations were measured for 6 days. We compared the characteristics and serial suPAR and CRP concentrations of patients with and without an infection using Chi-squared, Fisher’s exact, t-test and Mann-Whitney tests as appropriate, and calculated the area under the receiver operating characteristics curve (AUC). Results: Data of 55 patients with AKI stage 2/3 were analysed (62% male; mean age 60.5) of whom 43 patients received continuous renal replacement therapy. suPAR was not detectable in effluent fluid. There was no significant correlation between daily suPAR and CRP concentrations. In patients with an infection, suPAR results were significantly higher than in those without an infection across all time points; there was no significant difference in CRP levels between both groups.
    [Show full text]
  • Urinary Supar: a Non-Invasive Biomarker of Infection and Tissue James P
    Urinary suPAR: a non-invasive biomarker of infection and royalsocietypublishing.org/journal/rsos tissue inflammation for use in studies of large free-ranging Research Cite this article: Higham JP, Stahl-Hennig C, mammals Heistermann M. 2020 Urinary suPAR: a non-invasive biomarker of infection and tissue James P. Higham1, Christiane Stahl-Hennig2 inflammation for use in studies of large free- ranging mammals. R. Soc. open sci. 7: 191825. and Michael Heistermann3 http://dx.doi.org/10.1098/rsos.191825 1Department of Anthropology, New York University, 25 Waverly Place, New York, NY 10003, USA 2Unit of Infection Models, and 3Endocrinology Laboratory, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Göttingen 37077, Germany Received: 17 October 2019 JPH, 0000-0002-1133-2030 Accepted: 17 January 2020 Studies of large free-ranging mammals incorporating physiological measurements typically require the collection of urine or faecal samples, due to ethical and practical concerns over trapping or darting animals. However, there is a dearth of Subject Category: validated biomarkers of immune activation and inflammation Organismal and Evolutionary Biology that can be measured non-invasively. We here evaluate the utility of urinary measurements of the soluble form of the Subject Areas: urokinase plasminogen activator receptor (suPAR), for use as a behaviour/ecology/evolution health marker in studies of wild large mammals. We investigate how urinary suPAR concentrations change in response to viral infection and surgical trauma (inflammation), comparing it to Keywords: the measurement of a marker of cellular immune activation, behaviour, non-invasive, physiology, urinary neopterin (uNEO), in captive rhesus macaques. We then inflammation, field studies test the field utility of urinary suPAR, assessing the effects of soil and faecal contamination, sunlight, storage at different temperatures, freeze–thaw cycles, and lyophilization.
    [Show full text]
  • Can Serum Soluble Urokinase Plasminogen Activator Receptor Be an Effective Marker in the Diagnosis of Appendicitis and Differentiation of Complicated Cases?
    ORIGINAL ARTICLE Can serum soluble urokinase plasminogen activator receptor be an effective marker in the diagnosis of appendicitis and differentiation of complicated cases? Melih Akın, M.D.,1 Başak Erginel, M.D.,1 Nihat Sever, M.D.,1 Kerem Özel, M.D.,2 Banu Bayraktar, M.D.,3 Abdullah Yıldız, M.D.,1 Çetin Ali Karadağ, M.D.,1 Meltem Tokel, M.D.,1 Ali İhsan Dokucu, M.D.1 1Department of Pediatric Surgery, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul-Turkey 2Department of Pediatric Surgery, İstanbul Bilim University Faculty of Medicine, İstanbul-Turkey 3Department of Microbiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul-Turkey ABSTRACT BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is a new biomarker of inflammation level. The aim of the study was to evaluate whether suPAR levels could be useful to detect acute appendicitis and to differentiate uncomplicated appen- dicitis (UA) from complicated appendicitis (CA). METHODS: We prospectively studied 105 patients consisting of 40 UA cases, 40 CA cases, and 25 control patients. Blood samples were collected to measure suPAR level, C-reactive protein level, leukocyte counts, neutrophil counts, and neutrophil percentages preoperatively. RESULTS: Median values of suPAR level, C-reactive protein level, leukocyte counts, neutrophil counts, and neutrophil percentages in UA and CA were significantly higher than control patients. suPAR levels of the UA and CA groups showed a statistically significant difference (p=0.016). CONCLUSION: The current study demonstrated that serum suPAR concentrations can be helpful in differentiating CA from UA and in diagnosing acute appendicitis. Keywords: Complicated appendicitis; soluble urokinase plasminogen activator receptor; uncomplicated appendicitis.
    [Show full text]