Advancement in biomarker based effective diagnosis of neonatal sepsis

Gopal, Neha; Chauhan, Nidhi; Jain, Utkarsh; Dass, Sujata K.; Sharma, Hari S.; Chandra, Ramesh

doi:10.1080/21691401.2023.2252016

Cited by 8 publications

(2 citation statements)

References 137 publications

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“…Each of these biomarkers has been evaluated in various studies in recent years. 8 , 9 , 10 The Food and Drug Administration (FDA) approved the uses of C‐reactive protein (CRP) and procalcitonin (PCT) for the monitoring and diagnosis of sepsis in the clinical setting. 6 , 7 Even though PCT assays have presented encouraging results in the past decade, numerous limitations must be considered before using these tests in routine clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Nanobiosensors for procalcitonin (PCT) analysis

Mobed,

Darvishi,

Tahavvori

et al. 2024

Clinical Laboratory Analysis

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BackgroundProcalcitonin (PCT) is a critical biomarker that is released in response to bacterial infections and can be used to differentiate the pathogenesis of the infectious process.ObjectiveIn this article, we provide an overview of recent advances in PCT biosensors, highlighting different approaches for biosensor construction, different immobilization methods, advantages and roles of different matrices used, analytical performance, and PCT biosensor construction. Also, we will explain PCT biosensors sensible limits of detection (LOD), linearity, and other analytical characteristics. Future prospects for the development of better PCT biosensor systems are also discussed.MethodsTraditional methods such as capillary electrophoresis, high‐performance liquid chromatography, and mass spectrometry are effective in analyzing PCT in the medical field, but they are complicated, time‐consuming sample preparation, and require expensive equipment and skilled personnel.ResultsIn the past decades, PCT biosensors have emerged as simple, fast, and sensitive tools for PCT analysis in various fields, especially medical fields.ConclusionThese biosensors have the potential to accompany or replace traditional analytical methods by simplifying or reducing sample preparation and making field testing easier and faster, while significantly reducing the cost per analysis.

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Section: Introductionmentioning

confidence: 99%

Nanobiosensors for procalcitonin (PCT) analysis

Mobed,

Darvishi,

Tahavvori

et al. 2024

Clinical Laboratory Analysis

View full text Add to dashboard Cite

show abstract

“…Biomarkers for early infection diagnosis, including procalcitonin (PCT), Interleukin-6 (IL-6), and (CRP), have been extensively studied [ 12 – 14 ]. While these markers show promise, they also have limitations.…”

Section: Introductionmentioning

confidence: 99%

Rapid identification of early infections in febrile patients after CD19 target CAR-T cell therapy for B-cell malignancies

Pu,

Zheng,

Feng

et al. 2024

J Transl Med

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Background CD19-targeted chimeric antigen receptor T (CAR-T) cell therapy stands out as a revolutionary intervention, exhibiting remarkable remission rates in patients with refractory/relapsed (R/R) B-cell malignancies. However, the potential side effects of therapy, particularly cytokine release syndrome (CRS) and infections, pose significant challenges due to their overlapping clinical features. Promptly distinguishing between CRS and infection post CD19 target CAR-T cell infusion (CTI) remains a clinical dilemma. Our study aimed to analyze the incidence of infections and identify key indicators for early infection detection in febrile patients within 30 days post-CTI for B-cell malignancies. Methods In this retrospective cohort study, a cohort of 104 consecutive patients with R/R B-cell malignancies who underwent CAR-T therapy was reviewed. Clinical data including age, gender, CRS, ICANS, treatment history, infection incidence, and treatment responses were collected. Serum biomarkers procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) levels were analyzed using chemiluminescent assays. Statistical analyses employed Pearson’s Chi-square test, t-test, Mann–Whitney U-test, Kaplan–Meier survival analysis, Cox proportional hazards regression model, Spearman rank correlation, and receiver operating characteristic (ROC) curve analysis to evaluate diagnostic accuracy and develop predictive models through multivariate logistic regression. Results In this study, 38 patients (36.5%) experienced infections (30 bacterial, 5 fungal, and 3 viral) within the first 30 days of CAR T-cell infusion. In general, bacterial, fungal, and viral infections were detected at a median of 7, 8, and 9 days, respectively, after CAR T-cell infusion. Prior allogeneic hematopoietic cell transplantation (HCT) was an independent risk factor for infection (Hazard Ratio [HR]: 4.432 [1.262–15.565], P = 0.020). Furthermore, CRS was an independent risk factor for both infection ((HR: 2.903 [1.577–5.345], P < 0.001) and severe infection (9.040 [2.256–36.232], P < 0.001). Serum PCT, IL-6, and CRP were valuable in early infection prediction post-CAR-T therapy, particularly PCT with the highest area under the ROC curve (AUC) of 0.897. A diagnostic model incorporating PCT and CRP demonstrated an AUC of 0.903 with sensitivity and specificity above 83%. For severe infections, a model including CRS severity and PCT showed an exceptional AUC of 0.991 with perfect sensitivity and high specificity. Based on the aforementioned analysis, we proposed a workflow for the rapid identification of early infection during CAR-T cell therapy. Conclusions CRS and prior allogeneic HCT are independent infection risk factors post-CTI in febrile B-cell malignancy patients. Our identification of novel models using PCT and CRP for predicting infection, and PCT and CRS for predicting severe infection, offers potential to guide therapeutic decisions and enhance the efficacy of CAR-T cell therapy in the future.

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