DcR3, a new biomarker for sepsis, correlates with infection severity and procalcitonin
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Liqin Gao1,*, Bin Yang1,*, Hairong Zhang4,*, Qishui Ou1, Yulan Lin1, Mei Zhang2, Zhenhuan Zhang2, Sunghee Kim3, Bing Wu4,5, Zeng Wang4,5, Lengxi Fu4,5, Jingan Lin4,5, Ruiqing Chen4,5, Ruilong Lan4,5, Junying Chen4,5, Wei Chen4,5, Long Chen4,5, Hengshan Zhang4,5, Deping Han4,5, Jingrong Chen4,5, Paul Okunieff2, Jianhua Lin4,5 and Lurong Zhang4,5
1Department of Laboratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
2Department of Radiation Oncology, University of Florida, Gainesville, Florida 32610, USA
3BioPowerTech, Tuscaloosa, Alabama 35406, USA
4Fujian Key Laboratory of Individualized Active Immunotherapy, Fuzhou 350005, China
5Key Laboratory of Radiation Biology of Fujian Province Universities, Fuzhou 350005, China
*These authors contributed equally to this work
Jianhua Lin, email: [email protected]
Keywords: plasma DcR3; sepsis; early diagnosis; correlation with procalcitonin; clinical value
Received: July 19, 2017 Accepted: December 21, 2017 Published: December 28, 2017
Early diagnosis of sepsis is critical for successful treatment. The clinical value of DcR3 in early diagnosis of sepsis was determined in a dynamic follow-up study. Alterations in plasma levels of DcR3, PCT, CRP, and IL-6 were measured by ELISA and compared among patients with sepsis (n = 134), SIRS (n = 60) and normal adults (n = 50). Correlations and dynamic patterns among the biomarkers, APACHE II scores, clinical outcomes, and pathogens were also examined. Plasma DcR3 was significantly increased in sepsis compared to SIRS and normal adults (median 3.87 vs. 1.28 and 0.17 ng/ml). The elevated DcR3 could be detected in 97.60% sepsis patients 1–2 days prior to the result of blood culture reported. For diagnosis of sepsis, the sensitivity was 97.69% and specificity 98.04%; and for differential diagnosis of sepsis from SIRS, the sensitivity was 90.77% and specificity 98.40%. DcR3 level was positively correlated with severity of sepsis (rs = 0.82). In 41 patients who died of sepsis, DcR3 elevated as early as 1–2 days before blood culture and peaked on day 3 after blood culture performed. In 90% of sepsis patients, the dynamic alteration pattern of DcR3 was identical to that of PCT, while pattern of 10% patients differed in which clinical data was consistent with DcR3. In 13% sepsis patients, while PCT remained normal, DcR3 levels were at a high level. DcR3 levels had no difference among various pathogens infected. DcR3, a new biomarker, will aid in early diagnosis of sepsis and monitoring its outcome, especially when sepsis patients were PCT negative.
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