Abstract
Background. suPAR, the soluble form of the urokinase-type plasminogen activator receptor, has been identified as a biomarker of infection in adults but its properties in neonatal infection are not known. Methods. Plasma suPAR levels were determined by ELISA in 47 term neonates with infection (19 bacterial and 28 viral) and in 18 healthy neonates as controls. Thirteen out of 47 infected neonates were septic. In all infected neonates, suPAR levels were repeated at 24 hours, 48 hours, 3–5 days, and 7–10 days following admission. Results. Plasma suPAR levels were significantly increased in infected neonates upon admission, whereas they were highest in septic neonates, in comparison with controls (P < 0.001) and correlated positively with serum CRP levels (P = 0.001). At infection subsidence, suPAR concentrations decreased significantly in comparison with baseline (P < 0.001) but remained higher than in controls (P = 0.01). Receiver operating characteristic analysis resulted in significant areas under the curve for detecting either infected or septic neonates, but not for discriminating between bacterial and viral cause of infection. Conclusions. suPAR is a diagnostic biomarker of infection or sepsis in term neonates; however, it cannot discriminate bacterial from viral infections and also its utility for monitoring the response to treatment is questioned.
Highlights
It is well known that early diagnosis and management of neonatal infection is mandatory for outcome [1]
The white blood cells (WBC), absolute neutrophil count (ANC), and serum CRP values were significantly higher in neonates with bacterial infections than those with viral infections and controls; immature neutrophil count was higher, whereas platelet count was lower in neonates with bacterial infections but the difference between groups was not significant (Table 2)
According to the results of this study, circulating Soluble urokinase-type plasminogen activator receptor (suPAR) levels are increased in term neonates with acute infections in comparison with healthy controls
Summary
It is well known that early diagnosis and management of neonatal infection is mandatory for outcome [1]. The urokinase-type plasminogen activator receptor (uPAR), a membrane-linked receptor with extracellular protease activity that transduces intracellular signaling pathways, is expressed on the surface of several inflammatory cells, including neutrophils, lymphocytes, and monocytes, as well as on endothelial cells [3]. SuPAR, the soluble form of the urokinase-type plasminogen activator receptor, has been identified as a biomarker of infection in adults but its properties in neonatal infection are not known. Plasma suPAR levels were significantly increased in infected neonates upon admission, whereas they were highest in septic neonates, in comparison with controls (P < 0.001) and correlated positively with serum CRP levels (P = 0.001). SuPAR is a diagnostic biomarker of infection or sepsis in term neonates; it cannot discriminate bacterial from viral infections and its utility for monitoring the response to treatment is questioned Conclusions. suPAR is a diagnostic biomarker of infection or sepsis in term neonates; it cannot discriminate bacterial from viral infections and its utility for monitoring the response to treatment is questioned
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