Serum Procalcitonin and Presepsin Levels in Patients with Generalized Pustular Psoriasis
Serum Procalcitonin and Presepsin Levels in Patients with Generalized Pustular Psoriasis
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DOI：
10.1155/2018/9758473
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Yamanishi, Kiyofumi
中科院分区：
文献类型：
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作者：
Nagai, Makoto;Imai, Yasutomo;Yamanishi, Kiyofumi
全身性脓疱性银屑病（GPP）患者通常表现出必须与败血症相鉴别的症状。降钙素原（PCT）和降钙素原（P-SEP）被广泛用作脓毒症的生物标志物；因此，我们检测了银屑病患者血清PCT和P-SEP水平。纳入的患者包括寻常型银屑病（PV）患者27例（男性22例，女性5例，平均年龄47.7岁），银屑病关节炎（PsA）患者12例（男性8例，女性4例，平均年龄51.3岁），GPP患者15例（男性10例，女性5例，平均年龄63.7岁）。PV、PsA和GPP患者的平均血清PCT水平分别为0.01ng/mL（25 -75百分位；0.00-0.03）、0.013ng/mL（0.00-0.03）和0.12ng/mL (0.05-0.18)；GPP患者的PCT水平高于PV或PsA，但低于诊断感染的PCT临界值（0.5ng/mL）。PV、PsA和GPP患者的平均血清P-SEP水平分别为144.9pg/mL（25 -75百分位；78-181）、168.1pg/mL（124-203）和479.9pg/mL（216-581）。出乎意料的是，GPP患者的P-SEP水平与用于诊断感染的P-SEP临界值（317 ~ 647pg/mL）一样高。我们还发现中性粒细胞产生P-SEP，这表明GPP患者血清中P-SEP的高水平可能至少部分是由于GPP中活化的中性粒细胞产生的P-SEP。因此，血清PCT和P-SEP可能作为GPP的新型血清生物标志物有用，因为它们的水平在GPP治疗后降低。然而，在区分GPP和脓毒症方面，PCT的测定可能比P-SEP的测定更有用。
Patients with generalized pustular psoriasis (GPP) often present with symptoms that must be differentiated from sepsis. Procalcitonin (PCT) and presepsin (P-SEP) are widely used as biomarkers for sepsis; therefore, we examined the serum PCT and P-SEP levels in patients with psoriatic diseases. The enrolled patients included 27 with psoriasis vulgaris (PV) (22 males, 5 females; mean age 47.7 years), 12 with psoriatic arthritis (PsA) (8 males, 4 females; mean age 51.3 years), and 15 with GPP (10 males, 5 females; mean age 63.7 years). The mean serum PCT levels in patients with PV, PsA, and GPP were 0.01ng/mL (25th-75th percentile; 0.00-0.03), 0.013ng/mL (0.00-0.03), and 0.12ng/mL (0.05-0.18), respectively; the levels of PCT were higher for patients with GPP than with PV or PsA but were lower than the PCT cutoff value (0.5ng/mL) for the diagnosis of infection. The mean serum P-SEP levels in patients with PV, PsA, and GPP were 144.9pg/mL (25th-75th percentile; 78-181), 168.1pg/mL (124-203), and 479.9pg/mL (216-581), respectively. Unexpectedly, the levels of P-SEP in the patients with GPP were as high as the P-SEP cutoff value (317 to 647pg/mL) used for the diagnosis of infection. We also found that neutrophils produced P-SEP, suggesting that the high serum P-SEP levels in patients with GPP might arise at least in part due to the P-SEP derived from neutrophils activated in GPP. Both serum PCT and P-SEP might therefore be useful as novel serum biomarkers for GPP because their levels were decreased by GPP treatments. However, the measurement of PCT might be more useful than the measurement of P-SEP for discriminating between GPP and sepsis.