High presepsin concentrations in bile and its marked elevation in biliary tract diseases: A retrospective analysis
High presepsin concentrations in bile and its marked elevation in biliary tract diseases: A retrospective analysis
复制标题
胆汁中高浓度的前蛋白酶及其在胆道疾病中的显着升高：回顾性分析
DOI：
10.1016/j.cca.2021.07.025
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发表时间：
2021
影响因子：
5
通讯作者：
Shimizu N
中科院分区：
文献类型：
--
作者：
Yamaguchi T;Ohira M;Kawagoe N;Nakamura S;Tanaka S;Oka R;Watanabe Y;Sato Y;Nagayama D;Saiki A;Matsuzawa Y;Bujo H;Terai K;Hiruta N;Tatsuno I;Nakaseko C;Kikuchi H;Matsuoka K;Yokota H;Shimizu N
背景前体蛋白是细菌感染和脓毒症的诊断和预后生物标志物;然而，前体蛋白水平升高也可在无脓毒症的情况下观察到。我们进行了几项分析，以评估临床实验室参数影响presepsin levels.MethodWe分析序贯器官衰竭评估（SOFA）评分和血浆presepsin水平之间的关联，然后分析了567例患者的临床实验室参数与单变量和多变量回归分析和协方差分析（ANCOVA）。结果Spearman秩相关分析显示，前蛋白水平与对数转换的SOFA评分（ρ = 0.541）、碱性磷酸酶（ALP）（ρ = 0.454）和γ-谷氨酰转移酶（ρ = 0.505）密切相关。多变量回归分析显示，对数转换的SOFA评分（β系数= 0.316）、ALP水平（β系数= 0.380）和肌酐水平（β系数= 0.290）独立且显著地影响logepresepsin水平。协方差分析显示，前体蛋白水平显着较高的肝胆疾病患者。表现为胆管扩张和ALP水平或总胆红素水平升高的患者在胆汁中表现出高前体素水平。肝枯否细胞中的Presepsin生产也证实了immunostaining.Conclusionpresepsin水平与胆汁酶的升高在没有肾功能不全或脓毒症的患者。此外，前蛋白在胆汁中以高浓度存在，并在枯否细胞中呈阳性。
BackgroundPresepsin is a diagnostic and prognostic biomarker of both bacterial infection and sepsis; however, elevated presepsin levels have also been observed without sepsis. We conducted several analyses to evaluate the clinical laboratory parameters affecting presepsin levels.MethodWe analyzed the association between sequential organ failure assessment (SOFA) scores and plasma presepsin levels and then analyzed clinical laboratory parameters in 567 patients with univariate and multivariate regression analysis and analysis of covariance (ANCOVA). We also determined presepsin in the bile of 11 patients and examined the presepsin immunostaining in liver.ResultsSpearman’s rank correlation analysis with logechange revealed that presepsin levels were closely associated with loge-transformed SOFA score (ρ = 0.541), alkaline phosphatase (ALP); (ρ = 0.454) and gamma-glutamyl transferase; (ρ = 0.505). Multivariate regression analysis revealed that loge-transformed SOFA score (β-coefficient = 0.316), ALP level (β-coefficient = 0.380), and creatinine level (β-coefficient = 0.290) independently and significantly affected logepresepsin levels. ANCOVA revealed that presepsin levels were significantly higher in patients with hepatobiliary disease. Patients who presented with dilatation of the bile ducts and elevated ALP levels or total bilirubin levels exhibited high presepsin levels in the bile. Presepsin production in liver Kupffer cells was also confirmed by immunostaining.ConclusionPresepsin levels is correlated with the elevation of biliary enzymes in patients without renal dysfunction or sepsis. Additionally, presepsin exists with high concentrations in the bile and is positive in Kupffer cells.