Biomarkers of infection for the differential diagnosis of pleural effusions
We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and dis...
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Veröffentlicht in: | The European respiratory journal 2009-12, Vol.34 (6), p.1383-1389 |
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description | We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and discriminate between complicated (CPPEs) and uncomplicated parapneumonic effusions (UPPEs). Stored pleural fluid samples from 308 patients with different causes of pleural effusion were used to measure the four biomarkers. Receiver-operating characteristic analysis determined the accuracy of the new tests. Median pleural fluid levels of CRP, sTREM-1 and LBP were significantly higher in CPPE compared with those in other aetiologies. The area under the curve for distinguishing infectious (parapneumonics and tuberculosis) from noninfectious effusions was 0.87 for CRP, 0.86 for sTREM-1, 0.57 for PCT and 0.87 for LBP. Regarding the discrimination of nonpurulent CPPE versus UPPE, a multivariate analysis found that pleural fluid glucose < or =60 mg x dL(-1), LBP > or =17 microg x mL(-1) and CRP > or =80 mg x L(-1) were the best parameters. Individually, none of the new biomarkers achieved better performance characteristics than pH, glucose or lactate dehydrogenase in labelling CPPE. In conclusion, elevated pleural fluid levels of CRP, sTREM and LBP identify patients with infectious effusions, particularly those with CPPE. PCT has no value for the differential diagnosis of pleural effusions. |
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M ; Vives, M ; Cao, G ; Bielsa, S ; Ruiz-Gonzalez, A ; Martinez-Iribarren, A ; Esquerda, A</creator><creatorcontrib>Porcel, J. M ; Vives, M ; Cao, G ; Bielsa, S ; Ruiz-Gonzalez, A ; Martinez-Iribarren, A ; Esquerda, A</creatorcontrib><description>We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and discriminate between complicated (CPPEs) and uncomplicated parapneumonic effusions (UPPEs). Stored pleural fluid samples from 308 patients with different causes of pleural effusion were used to measure the four biomarkers. Receiver-operating characteristic analysis determined the accuracy of the new tests. Median pleural fluid levels of CRP, sTREM-1 and LBP were significantly higher in CPPE compared with those in other aetiologies. The area under the curve for distinguishing infectious (parapneumonics and tuberculosis) from noninfectious effusions was 0.87 for CRP, 0.86 for sTREM-1, 0.57 for PCT and 0.87 for LBP. Regarding the discrimination of nonpurulent CPPE versus UPPE, a multivariate analysis found that pleural fluid glucose < or =60 mg x dL(-1), LBP > or =17 microg x mL(-1) and CRP > or =80 mg x L(-1) were the best parameters. Individually, none of the new biomarkers achieved better performance characteristics than pH, glucose or lactate dehydrogenase in labelling CPPE. In conclusion, elevated pleural fluid levels of CRP, sTREM and LBP identify patients with infectious effusions, particularly those with CPPE. PCT has no value for the differential diagnosis of pleural effusions.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1183/09031936.00197208</identifier><identifier>PMID: 19541708</identifier><language>eng</language><publisher>Leeds: Eur Respiratory Soc</publisher><subject>Acute-Phase Proteins - biosynthesis ; Adult ; Aged ; Aged, 80 and over ; Bacterial diseases ; Bacterial diseases of the respiratory system ; Biological and medical sciences ; Biomarkers - metabolism ; C-Reactive Protein - metabolism ; Calcitonin - biosynthesis ; Calcitonin Gene-Related Peptide ; Carrier Proteins - biosynthesis ; Diagnosis, Differential ; Female ; Human bacterial diseases ; Humans ; Infectious diseases ; Lipopolysaccharides - metabolism ; Male ; Medical sciences ; Membrane Glycoproteins - biosynthesis ; Middle Aged ; Pleural Effusion - diagnosis ; Pleural Effusion - immunology ; Pleural Effusion - metabolism ; Pneumology ; Protein Precursors - biosynthesis ; Pulmonary Medicine - methods ; Receptors, Immunologic - biosynthesis ; Respiratory system : syndromes and miscellaneous diseases ; Triggering Receptor Expressed on Myeloid Cells-1</subject><ispartof>The European respiratory journal, 2009-12, Vol.34 (6), p.1383-1389</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-1ec2e84053789531d59cc4a34f096a10518529f3b51333f5f1e5ee9f03c4446a3</citedby><cites>FETCH-LOGICAL-c470t-1ec2e84053789531d59cc4a34f096a10518529f3b51333f5f1e5ee9f03c4446a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22162323$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19541708$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Porcel, J. M</creatorcontrib><creatorcontrib>Vives, M</creatorcontrib><creatorcontrib>Cao, G</creatorcontrib><creatorcontrib>Bielsa, S</creatorcontrib><creatorcontrib>Ruiz-Gonzalez, A</creatorcontrib><creatorcontrib>Martinez-Iribarren, A</creatorcontrib><creatorcontrib>Esquerda, A</creatorcontrib><title>Biomarkers of infection for the differential diagnosis of pleural effusions</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and discriminate between complicated (CPPEs) and uncomplicated parapneumonic effusions (UPPEs). Stored pleural fluid samples from 308 patients with different causes of pleural effusion were used to measure the four biomarkers. Receiver-operating characteristic analysis determined the accuracy of the new tests. Median pleural fluid levels of CRP, sTREM-1 and LBP were significantly higher in CPPE compared with those in other aetiologies. The area under the curve for distinguishing infectious (parapneumonics and tuberculosis) from noninfectious effusions was 0.87 for CRP, 0.86 for sTREM-1, 0.57 for PCT and 0.87 for LBP. Regarding the discrimination of nonpurulent CPPE versus UPPE, a multivariate analysis found that pleural fluid glucose < or =60 mg x dL(-1), LBP > or =17 microg x mL(-1) and CRP > or =80 mg x L(-1) were the best parameters. Individually, none of the new biomarkers achieved better performance characteristics than pH, glucose or lactate dehydrogenase in labelling CPPE. In conclusion, elevated pleural fluid levels of CRP, sTREM and LBP identify patients with infectious effusions, particularly those with CPPE. PCT has no value for the differential diagnosis of pleural effusions.</description><subject>Acute-Phase Proteins - biosynthesis</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the respiratory system</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>C-Reactive Protein - metabolism</subject><subject>Calcitonin - biosynthesis</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Carrier Proteins - biosynthesis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Lipopolysaccharides - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Membrane Glycoproteins - biosynthesis</subject><subject>Middle Aged</subject><subject>Pleural Effusion - diagnosis</subject><subject>Pleural Effusion - immunology</subject><subject>Pleural Effusion - metabolism</subject><subject>Pneumology</subject><subject>Protein Precursors - biosynthesis</subject><subject>Pulmonary Medicine - methods</subject><subject>Receptors, Immunologic - biosynthesis</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Triggering Receptor Expressed on Myeloid Cells-1</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0MtOxCAUBmBiNDpeHsCN6UZdVTk90JalTrxFEze6JgxzmEE77QhtjG8v44y6IsB3fsLP2DHwC4AaL7niCArLC85BVQWvt9gIUKkcOcdtNlrd5yuwx_ZjfEuqFAi7bA-UFFDxesQer323MOGdQsw6l_nWke1912auC1k_p2zqnaNAbe9NkzZm1nbR_9hlQ0NIh-TcENNIPGQ7zjSRjjbrAXu9vXkZ3-dPz3cP46un3IqK9zmQLagWXGJVK4kwlcpaYVA4rkoDXEItC-VwIgERnXRAkkg5jlYIURo8YOfr3GXoPgaKvV74aKlpTEvdEHWFWBYoizpJWEsbuhgDOb0MPn33SwPXqwr1b4X6t8I0c7JJHyYLmv5PbDpL4HQDTLSmccG01sc_VxSQXi8wubO1m_vZ_NMH0nFhmibFgqbwhkKXGrBG_AamAISe</recordid><startdate>20091201</startdate><enddate>20091201</enddate><creator>Porcel, J. M</creator><creator>Vives, M</creator><creator>Cao, G</creator><creator>Bielsa, S</creator><creator>Ruiz-Gonzalez, A</creator><creator>Martinez-Iribarren, A</creator><creator>Esquerda, A</creator><general>Eur Respiratory Soc</general><general>Maney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20091201</creationdate><title>Biomarkers of infection for the differential diagnosis of pleural effusions</title><author>Porcel, J. M ; Vives, M ; Cao, G ; Bielsa, S ; Ruiz-Gonzalez, A ; Martinez-Iribarren, A ; Esquerda, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-1ec2e84053789531d59cc4a34f096a10518529f3b51333f5f1e5ee9f03c4446a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute-Phase Proteins - biosynthesis</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the respiratory system</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>C-Reactive Protein - metabolism</topic><topic>Calcitonin - biosynthesis</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Carrier Proteins - biosynthesis</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Lipopolysaccharides - metabolism</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Membrane Glycoproteins - biosynthesis</topic><topic>Middle Aged</topic><topic>Pleural Effusion - diagnosis</topic><topic>Pleural Effusion - immunology</topic><topic>Pleural Effusion - metabolism</topic><topic>Pneumology</topic><topic>Protein Precursors - biosynthesis</topic><topic>Pulmonary Medicine - methods</topic><topic>Receptors, Immunologic - biosynthesis</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Triggering Receptor Expressed on Myeloid Cells-1</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Porcel, J. M</creatorcontrib><creatorcontrib>Vives, M</creatorcontrib><creatorcontrib>Cao, G</creatorcontrib><creatorcontrib>Bielsa, S</creatorcontrib><creatorcontrib>Ruiz-Gonzalez, A</creatorcontrib><creatorcontrib>Martinez-Iribarren, A</creatorcontrib><creatorcontrib>Esquerda, A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European respiratory journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Porcel, J. M</au><au>Vives, M</au><au>Cao, G</au><au>Bielsa, S</au><au>Ruiz-Gonzalez, A</au><au>Martinez-Iribarren, A</au><au>Esquerda, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biomarkers of infection for the differential diagnosis of pleural effusions</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>2009-12-01</date><risdate>2009</risdate><volume>34</volume><issue>6</issue><spage>1383</spage><epage>1389</epage><pages>1383-1389</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>We aimed to investigate whether pleural fluid concentrations of biomarkers for bacterial infection, namely triggering receptor expressed on myeloid cells (sTREM-1), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP), might identify infectious effusions and discriminate between complicated (CPPEs) and uncomplicated parapneumonic effusions (UPPEs). Stored pleural fluid samples from 308 patients with different causes of pleural effusion were used to measure the four biomarkers. Receiver-operating characteristic analysis determined the accuracy of the new tests. Median pleural fluid levels of CRP, sTREM-1 and LBP were significantly higher in CPPE compared with those in other aetiologies. The area under the curve for distinguishing infectious (parapneumonics and tuberculosis) from noninfectious effusions was 0.87 for CRP, 0.86 for sTREM-1, 0.57 for PCT and 0.87 for LBP. Regarding the discrimination of nonpurulent CPPE versus UPPE, a multivariate analysis found that pleural fluid glucose < or =60 mg x dL(-1), LBP > or =17 microg x mL(-1) and CRP > or =80 mg x L(-1) were the best parameters. Individually, none of the new biomarkers achieved better performance characteristics than pH, glucose or lactate dehydrogenase in labelling CPPE. In conclusion, elevated pleural fluid levels of CRP, sTREM and LBP identify patients with infectious effusions, particularly those with CPPE. PCT has no value for the differential diagnosis of pleural effusions.</abstract><cop>Leeds</cop><pub>Eur Respiratory Soc</pub><pmid>19541708</pmid><doi>10.1183/09031936.00197208</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acute-Phase Proteins - biosynthesis Adult Aged Aged, 80 and over Bacterial diseases Bacterial diseases of the respiratory system Biological and medical sciences Biomarkers - metabolism C-Reactive Protein - metabolism Calcitonin - biosynthesis Calcitonin Gene-Related Peptide Carrier Proteins - biosynthesis Diagnosis, Differential Female Human bacterial diseases Humans Infectious diseases Lipopolysaccharides - metabolism Male Medical sciences Membrane Glycoproteins - biosynthesis Middle Aged Pleural Effusion - diagnosis Pleural Effusion - immunology Pleural Effusion - metabolism Pneumology Protein Precursors - biosynthesis Pulmonary Medicine - methods Receptors, Immunologic - biosynthesis Respiratory system : syndromes and miscellaneous diseases Triggering Receptor Expressed on Myeloid Cells-1 |
title | Biomarkers of infection for the differential diagnosis of pleural effusions |
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