Procalcitonin Article Image

Following on the heels of its January 2019 special issue on sepsis, the Journal of Applied Laboratory Medicine (JALM) will dive deeper into this topic in the scientific session, Journal of Applied Laboratory Medicine’s 2019 Hot Topics: Sepsis Diagnosis and Management: Role of Novel Biomarkers and Procalcitonin Confounders (34108) at the 71st AACC Annual Scientific Meeting & Clinical Lab Expo in Anaheim California.

Despite concentrated efforts to improve sepsis care and a robust research pipeline to better understand the syndrome’s etiology and identify more effective treatments, sepsis remains a high-mortality condition, causing up to one-third of hospital deaths. Critical biomarkers are needed to guide therapeutic approaches, so they can be as precise and patient-centered as possible, session moderator and JALM editor-in-chief Robert Christenson, PhD, told CLN Stat. “The focus of our session will be how novel biomarkers can help meet this need, as well as caveats with biomarkers that are currently used for guiding therapy,” added Christenson, professor of pathology and professor of medical and research technology at the University of Maryland School of Medicine in Baltimore.

Procalcitonin (PCT) as well as two novel markers, human neutrophil lipocalin and nitric oxide synthase, take center stage at this session. The latter two “are sentinels/actors in the pathophysiology of sepsis. As such, they bring broader mechanistic understanding for identifying the cause for sepsis and for targeting therapy,” explained Christenson, who plans to discuss human neutrophil lipocalin’s use in early diagnosis and monitoring of acute infections.

Richard Sweet, MD, a nephrologist at UCSF Medical Center, will focus on inducible nitric oxide synthase’s uses as a diagnostic for sepsis. Both markers need additional validation in properly designed clinical trials before being adopted in clinical practice, Christenson observed. “Although there is a growing body of literature for what these biomarkers add, a trial demonstrating that patients who have this testing fare better than patients who do not will put the biomarkers on the diagnostic and therapeutic ‘map,’” he said.

Rounding out the session, Jessica Colȯn-Franco, PhD, DABCC, a clinical chemist at Cleveland Clinic, plans to expound on the pros and cons of PCT. The fact that PCT only indicates a bacterial etiology, not viral causes, is a limitation. “Also, the pathophysiological insights that procalcitonin measurements provide for understanding the cellular dysfunction, inflammatory pathways and disturbed regional blood flow involved in sepsis is limited because the function of this biomarker is not fully elucidated,” according to Christenson.

Attend this session on August 7 from 10:30 a.m. to noon and earn 1.5 ACCENT credit hours.