Hepatocyte Growth Factor Is a Reliable Marker for Efficient Anti-Bacterial Therapy within the First Day of Treatment

Ingela Nilsson,Hossin Abednazari,Lars Brudin,Fariba Nayeri,Gabriel Almroth

doi:10.4236/abb.2014.510096

Abstract

Rapid diagnosis and choice of appropriate antibiotic treatment might be life-saving in serious infectious diseases. Still the available markers that can evaluate and monitor the diagnosis and treatment are few. Hepatocyte growth factor (HGF) has been studied as a potent regenerative factor produced and released during injuries such as infectious diseases. Monitoring of HGF levels might predict therapy results better than C-reactive protein (CRP) within the first day of treatment in pneumonia. For further investigation of previous observations we aimed to study HGF as a first-day marker in over-representing infectious diseases in comparison to procalcitonin (PCT), CRP and body temperature. Fifty-one patients with community acquired infectious diseases were included consequently at admittance and the serum samples were collected before and within 18 - 24 hours of treatment. HGF levels decreased significantly in case of efficient antibiotic therapy and HGF was shown to be better than PCT, CRP and body temperature to evaluate treatment. In patients with pneumonia, monitoring of HGF was most reasonable. HGF might be used as a therapeutic marker within the first day of empiric antibiotic treatment during infection.

Highlights

Patients with bacterial infections are at high risk of developing serious complications, such as septic shock and multiple organ failure, if treatment is not initiated in a timely manner
We showed that Hepatocyte growth factor (HGF) concentration increased in serum and exhaled-breath condensate in patients with pneumonia [13] and that the amount of HGF decreased markedly within 48 hours of initiation of the appropriate antibiotic therapy [14]
We showed that HGF predicted the results of antibiotic therapy better than C-reactive protein (CRP) did within 24 hours of initiation of pneumonia treatment [15]

Summary

Introduction

Patients with bacterial infections are at high risk of developing serious complications, such as septic shock and multiple organ failure, if treatment is not initiated in a timely manner. Empiric antibiotic treatment is initiated as soon as infection is suspected and cultures and/or other diagnostic tests are procured. It can take several days before culture results are available and an appropriate antibiotic regime is chosen. The physician must decide to continue or change the initial choice of antibiotic. Most physicians choose to examine additional markers at early stages, in high-risk patients admitted to intensive care units so that therapy may be closely evaluated [1]. Monitoring body temperature [2], C-reactive protein (CRP) [3] [4], procalcitonin (PCT) [5] and interleukin 6 (IL-6) [6] are some of the more commonly used markers

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Conclusion