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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Vaccine+Immunol
2015 ; 22
(9
): 1025-32
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Human Neutrophil Lipocalin as a Superior Diagnostic Means To Distinguish between
Acute Bacterial and Viral Infections
#MMPMID26135974
Venge P
; Douhan-Håkansson L
; Garwicz D
; Peterson C
; Xu S
; Pauksen K
Clin Vaccine Immunol
2015[Sep]; 22
(9
): 1025-32
PMID26135974
show ga
The distinction between causes of acute infections is a major clinical challenge.
Current biomarkers, however, are not sufficiently accurate. Human neutrophil
lipocalin (HNL) concentrations in serum or whole blood activated by
formyl-methionine-leucine-phenylalanine (fMLP) were shown to distinguish acute
infections of bacterial or viral cause with high accuracy. The aim was therefore
to compare the clinical performance of HNL with currently used biomarkers. Seven
hundred twenty-five subjects (144 healthy controls and 581 patients with signs
and symptoms of acute infections) were included in the study. C-reactive protein
(CRP), the expression of CD64 on neutrophils, procalcitonin (PCT), and blood
neutrophil counts were measured by established techniques, and HNL concentrations
were measured in whole-blood samples after activation with fMLP. All tested
biomarkers were elevated in bacterial as opposed to viral infections (P < 0.001).
CRP, PCT, and CD64 expression in neutrophils was elevated in viral infections
compared to healthy controls (P < 0.001). In the distinction between healthy
controls and patients with bacterial infections, the areas under the receiver
operating characteristic (ROC) curves were >0.85 for all biomarkers, whereas for
the distinction between bacterial and viral infections, only HNL concentration in
fMLP-activated whole blood showed an area under the ROC curve (AUROC) of >0.90
and superior clinical performance. The clinical performance of HNL in
fMLP-activated whole blood was superior to current biomarkers and similar to
previous results of HNL in serum. The procedure can be adopted for point-of-care
testing with response times of <15 min.