Abstract
BackgroundPancreatic stone protein (PSP) has been identified as a promising sepsis marker in adults, children and neonates. However, data on population-based reference values are lacking. This study aimed to establish age-specific reference values for PSP.MethodsPSP was determined using a specific ELISA. PSP serum concentrations were determined in 372 healthy subjects including 217 neonates, 94 infants and children up to 16 years, and 61 adults. The adjacent categories method was used to determine which age categories had significantly different PSP concentrations.ResultsPSP circulating levels were not gender-dependent and ranged from 1.0 to 99.4 ng/ml with a median of 9.2 ng/ml. PSP increased significantly between the age categories, from a median of 2.6 ng/ml in very preterm newborns, to 6.3 ng/ml in term newborns, to 16.1 ng/ml in older children (p < 0.001). PSP levels were higher on postnatal day three compared to levels measured immediately post delivery (p < 0.001). Paired umbilical artery and umbilical vein samples were strongly correlated (p < 0.001). Simultaneously obtained capillary heel-prick versus venous samples showed a good level of agreement for PSP (Rho 0.89, bias 19 %).ConclusionsThis study provides age-specific normal values that may be used to define cut-offs for future trials on PSP. We demonstrate an age-dependent increase of PSP from birth to childhood.
Highlights
Pancreatic stone protein (PSP) has been identified as a promising sepsis marker in adults, children and neonates
PSP serum concentrations were determined in 372 healthy subjects including 217 neonates, 94 infants and children up to 16 years; and 61 adults
We report on age-specific serum concentrations in PSP in healthy individuals
Summary
Pancreatic stone protein (PSP) has been identified as a promising sepsis marker in adults, children and neonates. A limitation of several recently proposed infection markers is the lack of larger cohorts providing populational serum concentration measurements in order to establish normal reference values. This is important because the performance of most biomarkers is context-sensitive and in some cases age-specific. A study using a bioscore combinding PSP with procalcitonin (PCT) significantly improved the ability to diagnose neonatal early-onset sepsis, with a negative predictive value of 100 % if both PSP and PCT were negative [10] These data suggest that PSP is a promising candidate for further studies assessing performance and use in clinical practice. Animal studies have shown induction of PSP expression in Schlapbach et al BMC Anesthesiology (2015) 15:168 subsets of intestinal and gastric cells by stress conditions in the absence of direct pancreatic inflammation [11]
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