Abstract：Objective To evaluate the value of pancreatic stone protein/regenerating protein (PSP/reg) in severity evaluation and prognosis prediction for children with sepsis. Methods In this prospective case-control study, 159 children with sepsis (106 cases in the sepsis group; 53 cases in the severe sepsis group, including 12 cases of septic shock) and 20 children without sepsis (control group) were enrolled. ELISA was applied to measure plasma PSP/reg levels on days 1, 3, and 7 of admission to the PICU. The Spearman rank correlation test was applied to assess the correlations between plasma PSP/reg level and serum procalcitonin (PCT), CRP, WBC count, and pediatric critical illness score (PCIS). The area under the receiver operating characteristic curve (AUC) was used to assess the value of each index in determining severity and predicting prognosis for children with sepsis. Results On day 1 of admission to the PICU, plasma PSP/reg levels in the sepsis and severe sepsis groups were significantly higher than in the control group (PPn=132) had a significantly lower plasma PSP/reg level than the non-survival group (n=27) (Prs=0.212 and 0.548, respectively; both Prs=-0.373; PPConclusions PSP/reg is closely related to infection, and has a certain clinical value in risk stratification of sepsis and prognosis evaluation.
PENG Hong-Yan,ZHU Yi-Min,ZHANG Xin-Ping et al. Value of pancreatic stone protein/regenerating protein in severity evaluation and prognosis prediction for children with sepsis[J]. CJCP, 2015, 17(11): 1183-1188.
Chakravarthy M, Kavaraganahalli D, Pargaonkar S, et al. Elevated postoperative serum procalcitonin is not indicative of bacterial infection in cardiac surgical patients[J]. Ann Card Anaesth, 2015, 18(2): 210-214.
[2]
Kobayashi S, Akiyama T, Nata K, et al. Identification of a receptor for reg (regenerating gene) protein, a pancreatic beta-cell regeneration factor[J]. J Biol Chem, 2000, 275(15): 10723-10726.
[3]
Busani S, Girardis M. PSP/reg: a new stone in sepsis biomarkers?[J]. Crit Care, 2012, 16(4): 143.
[4]
Fisher OM, Oberkofler CE, Raptis DA, et al. Pancreatic stone protein (PSP) and pancreatitis-associated protein (PAP): a protocol of a cohort study on the diagnostic efficacy and prognostic value of PSP and PAP as postoperative markers of septic complications in patients undergoing abdominal surgery (PSP study)[J]. BMJ Open, 2014, 4(3): e4914.
[5]
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics[J]. Pediatr Crit Care Med, 2005, 6(1): 2-8.
[6]
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J]. Crit Care Med, 2003, 31(4): 1250-1256.
[7]
Barati M, Alinejad F, Bahar MA, et al. Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases[J]. Burns, 2008, 34(6): 770-774.
Palmiere C, Augsburger M. Pancreatic stone protein as a postmortem biochemical marker for the diagnosis of sepsis[J]. Leg Med (Tokyo), 2015, 17(1): 9-13.
[11]
Iovanna J, Frigerio JM, Dusetti N, et al. Lithostathine, an inhibitor of CaCO3 crystal growth in pancreatic juice, induces bacterial aggregation[J]. Pancreas, 1993, 8(5): 597-601.
[12]
Peterson KM, Guo X, Elkahloun AG, et al. The expression of REG 1A and REG 1B is increased during acute amebic colitis[J]. Parasitol Int, 2011, 60(3): 296-300.
[13]
Imaoka H, Ishihara S, Kazumori H, et al. Exacerbation of indomethacin-induced small intestinal injuries in Reg I-knockout mice[J]. Am J Physiol Gastrointest Liver Physiol, 2010, 299(2): G311-G319.
[14]
Sekikawa A, Fukui H, Zhang X, et al. REG Ialpha is a biomarker for predicting response to chemotherapy with S-1 plus cisplatin in patients with unresectable stage IV gastric cancer[J]. Br J Cancer, 2013, 108(2): 395-401.
[15]
Keel M, Harter L, Reding T, et al. Pancreatic stone protein is highly increased during posttraumatic sepsis and activates neutrophil granulocytes[J]. Crit Care Med, 2009, 37(5): 1642-1648.
[16]
Tatemichi N, Takahashi C, Hayakawa S, et al. Enzyme immunoassay and characterization of pancreatic stone proteins in human urine[J]. J Clin Lab Anal, 1993, 7(6): 365-370.
[17]
Schlapbach LJ, Graf R, Woerner A, et al. Pancreatic stone protein as a novel marker for neonatal sepsis[J]. Intensive Care Med, 2013, 39(4): 754-763.
[18]
Scherr A, Graf R, Bain M, et al. Pancreatic stone protein predicts positive sputum bacteriology in exacerbations of COPD[J]. Chest, 2013, 143(2): 379-387.
[19]
Gukasjan R, Raptis DA, Schulz HU, et al. Pancreatic stone protein predicts outcome in patients with peritonitis in the ICU[J]. Crit Care Med, 2013, 41(4): 1027-1036.
[20]
Llewelyn MJ, Berger M, Gregory M, et al. Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care[J]. Crit Care, 2013, 17(2): R60.
[21]
Jiri Z, Kyr M, Vavrina M, et al. Pancreatic stone protein - a possible biomarker of multiorgan failure and mortality in children sepsis[J]. Cytokine, 2014, 66(2): 106-111.
[22]
Boeck L, Graf R, Eggimann P, et al. Pancreatic stone protein: a marker of organ failure and outcome in ventilator-associated pneumonia[J]. Chest, 2011, 140(4): 925-932.
