Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants

Fischer, Joachim E.; Brunner, Anna; Janousek, Martin; Nadal, David; Blau, Nenad; Fanconi, Sergio

doi:10.1007/pl00008402

Cited by 3 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a mouse model, elevated IL-18 levels have been reported in neonatal group B streptococcal infections (60). Furthermore elevated levels of IL-18 have been documented in adult sepsis patients and correlate with adverse outcome and Acute Physiology and Chronic Health Evaluation (APACHE) II score (45,46).…”

Section: Differentiation Of Etiologic Agent Class By Examination Of Hmentioning

confidence: 99%

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Kennedy

Halliday

Velkinburgh

et al. 2008

Molecular & Cellular Proteomics

View full text Add to dashboard Cite

Infection is a leading cause of neonatal morbidity and mortality worldwide. Premature neonates are particularly susceptible to infection because of physiologic immaturity, comorbidity, and extraneous medical interventions. Additionally premature infants are at higher risk of progression to sepsis or severe sepsis, adverse outcomes, and antimicrobial toxicity. Currently initial diagnosis is based upon clinical suspicion accompanied by nonspecific clinical signs and is confirmed upon positive microbiologic culture results several days after institution of empiric therapy. There exists a significant need for rapid, objective, in vitro tests for diagnosis of infection in neonates who are experiencing clinical instability. We used immunoassays multiplexed on microarrays to identify differentially expressed serum proteins in clinically infected and non-infected neonates. Immunoassay arrays were effective for measurement of more than 100 cytokines in small volumes of serum available from neonates. Our analyses revealed significant alterations in levels of eight serum proteins in infected neonates that are associated with inflammation, coagulation, and fibrinolysis. Specifically P-and E-selectins, interleukin 2 soluble receptor ␣, interleukin 18, neutrophil elastase, urokinase plasminogen activator and its cognate receptor, and C-reactive protein were observed at statistically significant increased levels. Multivariate classifiers based on combinations of serum analytes exhibited better diagnostic specificity and sensitivity than single analytes. Multiplexed immunoassays of serum cytokines may have clinical utility as an adjunct for rapid diagnosis of infection and differentiation of etiologic agent in neonates with clinical decompensation.

show abstract

Section: Differentiation Of Etiologic Agent Class By Examination Of Hmentioning

confidence: 99%

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Kennedy

Halliday

Velkinburgh

et al. 2008

Molecular & Cellular Proteomics

View full text Add to dashboard Cite

show abstract

“…Of the 37 studies that were included, 17 (46%) clearly distinguished clinically septic infants from those who had true bacterial growth according to our criteria ( Table 2). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The cumulative sample sizes of these studies were small, even for the most frequently applied diagnostic tests. Because we deliberately chose bacterial growth as a criterion standard, the remaining 20 studies could not be further analyzed.…”

Section: Studies That Met Inclusion Criteriamentioning

confidence: 99%

“…Six tests in 8 studies had LRs of more than 10. 5,8,9,11,15,18,20,21 Of these studies, we were able to perform an independent verification that the positive LR was more than 10 in the study of procalcitonin by Gendrel et al 20 ; the studies of neutrophil CD11b by Weirich et al 18 and Nupponen et al 15 ; the study of IL-6 by Bhartiya et al 11 ; and the study of IL-8 by Nupponen et al 15 In total, 2 of 3 studies that evaluated procalcitonin levels 20,21 had a positive LR of more than 10.…”

Section: Performance Of the Individual Tests Evaluatedmentioning

confidence: 99%

Beyond the Complete Blood Cell Count and C-Reactive Protein

Malik¹,

Hui²,

Pennie³

et al. 2003

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

We found few methodologically rigorous studies of the accuracy of laboratory tests for the diagnosis of bacterial infection in newborns; in a significant proportion of studies, the accuracy of the tests could not be independently determined because of a lack of adequate data. There was marked heterogeneity in sample selection and cutoff levels for diagnosis of neonatal sepsis. A few tests showed promising accuracy, but there are insufficient data to support their confident use as clinical tools.

show abstract

Plasma neutrophil lipocalin, elastase‐α₁‐antitrypsin complex and neutrophil protease 4 in preterm infants with respiratory distress syndrome

Sveger¹,

Ohlsson²,

Mörse

et al. 2003

Scandinavian Journal of Clinical and Laboratory Investigation

View full text Add to dashboard Cite

Respiratory distress syndrome (RDS) and chronic lung disease of prematurity (CLD) are associated with inflammation of the airways and interstitial tissue of the lung. It is hypothesized that RDS severity and the risk of developing CLD may be correlated with neutrophil gelatinase-associated lipocalin (NGAL), a marker of leucocyte activity, human elastase-alpha1-antitrypsin complex (HEAT) or free and complexed neutrophil protease 4 (NP4), markers of proteolytic enzyme secretion from granulocytes. Thirty-three preterm infants with RDS were enrolled in the study and plasma sampled between 3 and 14 days of life. NGAL, HEAT and NP4 concentrations varied widely in infants with RDS. Significant correlations between subsequent development of CLD and plasma concentrations of HEAT and NP4, respectively, were found on days 3-4 of life, p=0.006 and p=0.02, respectively.

show abstract

Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants

Abstract: Determination of neutrophil elastase alpha1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times.

Cited by 3 publications

References 6 publications

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Beyond the Complete Blood Cell Count and C-Reactive Protein

Plasma neutrophil lipocalin, elastase‐α₁‐antitrypsin complex and neutrophil protease 4 in preterm infants with respiratory distress syndrome

Contact Info

Product

Resources

About

Diagnostic potential of neutrophil elastase inhibitor complex in the routine care of critically ill newborn infants

Abstract: Determination of neutrophil elastase alpha1-proteinase inhibitor levels yields diagnostic advantages comparable to those of manual differential counts but provide faster turnaround times.

Cited by 3 publications

References 6 publications

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Identification of Diagnostic Biomarkers for Infection in Premature Neonates

Beyond the Complete Blood Cell Count and C-Reactive Protein

Plasma neutrophil lipocalin, elastase‐α1‐antitrypsin complex and neutrophil protease 4 in preterm infants with respiratory distress syndrome

Contact Info

Product

Resources

About

Plasma neutrophil lipocalin, elastase‐α₁‐antitrypsin complex and neutrophil protease 4 in preterm infants with respiratory distress syndrome