Procalcitonin: Mysterious Protein in Sepsis
Procalcitonin: Mysterious Protein in Sepsis
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降钙素原：败血症中的神秘蛋白质
DOI：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
H. Utsunomiya
中科院分区：
文献类型：
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作者：
Misa Nakamura;Ryohei Kono;S. Nomura;H. Utsunomiya
感染性休克是重症监护病房死亡的主要原因，但在有急性炎症临床体征的重症患者中，很难与非感染性疾病区分开来。降钙素原（ProCT）是降钙素激素的前体，由116个氨基酸组成，分子量为13 kDa。与许多促炎细胞因子（例如，肿瘤坏死因子α和白细胞介素-1 β）在脓毒症的早期过程中上升和下降，脓毒症患者和全身性炎症患者的血清ProCT升高，与死亡率和疾病的严重程度相关，并且在相对长的时间段内保持升高。因此，ProCT似乎是脓毒症的重要标志物。在对微生物感染的反应中，ProCT可能在组织损伤中起致病作用，因为用ProCT中和抗血清治疗增加了脓毒症动物模型中的动物存活率。相反，在用内毒素刺激的人体中也报道了ProCT的抗炎作用。对ProCT临床作用的认识使人们对了解其调节和生物学作用的兴趣增加。本文就ProCT的生物学特性及其对临床医学的影响作一综述。
Septic shock is a leading cause of mortality in intensive care units, but can be difficult to distinguish from non-infectious conditions in critically ill patients admitted with clinical signs of acute inflammation. Procalcitonin (ProCT), the precursor of the hormone calcitonin, is composed of 116 amino acids and has a molecular weight of 13 kDa. In contrast to many pro-inflammatory cytokines (e.g., tumor necrosis factor alpha and interleukin-1 beta) that rise and decline in the early course of sepsis, serum ProCT is increased in patients with sepsis and those with systemic inflammation, correlates with the mortality and severity of illness, and remains elevated over a relatively long period of time. Hence, ProCT appears as an important marker of sepsis. In response to microbial infections, ProCT may play a causative role in the tissue damage because treatment with ProCT-neutralizing antiserum increases animal survival in the animal models of sepsis. Conversely, an anti-inflammatory effect of the ProCT has also been reported in humans stimulated with endotoxin. Awareness of the clinical effects of ProCT has led to increased interest in understanding its regulation and biological role. In this review, we first describe the biological characteristics of ProCT and then discuss its impact on the clinical medicine.