High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.

<h4>Introduction</h4>Long pentraxin 3 (PTX3) is an acute-phase protein secreted by various cells, including leukocytes and endothelial cells. Like C-reactive protein (CRP), it belongs to the pentraxin superfamily. Recent studies indicate that high levels of PTX3 may be associated with mo...

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Autores principales:	Reetta Huttunen, Mikko Hurme, Janne Aittoniemi, Heini Huhtala, Risto Vuento, Janne Laine, Juulia Jylhävä, Jaana Syrjänen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/68a94f0c37fd4d5a9280aef20eafd170
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spelling	oai:doaj.org-article:68a94f0c37fd4d5a9280aef20eafd1702021-11-18T06:57:30ZHigh plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.1932-620310.1371/journal.pone.0017653https://doaj.org/article/68a94f0c37fd4d5a9280aef20eafd1702011-03-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21423699/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Long pentraxin 3 (PTX3) is an acute-phase protein secreted by various cells, including leukocytes and endothelial cells. Like C-reactive protein (CRP), it belongs to the pentraxin superfamily. Recent studies indicate that high levels of PTX3 may be associated with mortality in sepsis. The prognostic value of plasma PTX3 in bacteremic patients is unknown.<h4>Methods</h4>Plasma PTX3 levels were measured in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic streptococcae and Escherichia coli, using a commercial solid-phase enzyme-linked immunosorbent assay (ELISA). Values were measured on days 1-4 after positive blood culture, on day 13-18 and on recovery.<h4>Results</h4>The maximum PTX3 values on days 1-4 were markedly higher in nonsurvivors compared to survivors (44.8 vs 6.4 ng/ml, p<0.001) and the AUC(ROC) in the prediction of case fatality was 0.82 (95% CI 0.73-0.91). PTX3 at a cut-off level of 15 ng/ml showed 72% sensitivity and 81% specificity for fatal disease. High PTX3 (>15 ng/ml) was associated with hypotension (MAP <70 mmHg)(OR 7.9;95% CI 3.3-19.0) and high SOFA score (≥4)(OR 13.2; 95% CI 4.9-35.4). The CRP level (maximum value on days 1 to 4) did not predict case fatality at any cut-off level in the ROC curve (p = 0.132). High PTX3 (>15 ng/ml) remained an independent risk factor for case fatality in a logistic regression model adjusted for potential confounders.<h4>Conclusions</h4>PTX3 proved to be a specific independent prognostic biomarker in bacteremia. PTX3 during the first days after diagnosis showed better prognostic value as compared to CRP, a widely used biomarker in clinical settings. PTX3 measurement offers a novel opportunity for the prognostic stratification of bacteremia patients.Reetta HuttunenMikko HurmeJanne AittoniemiHeini HuhtalaRisto VuentoJanne LaineJuulia JylhäväJaana SyrjänenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 3, p e17653 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Reetta Huttunen Mikko Hurme Janne Aittoniemi Heini Huhtala Risto Vuento Janne Laine Juulia Jylhävä Jaana Syrjänen High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
description	<h4>Introduction</h4>Long pentraxin 3 (PTX3) is an acute-phase protein secreted by various cells, including leukocytes and endothelial cells. Like C-reactive protein (CRP), it belongs to the pentraxin superfamily. Recent studies indicate that high levels of PTX3 may be associated with mortality in sepsis. The prognostic value of plasma PTX3 in bacteremic patients is unknown.<h4>Methods</h4>Plasma PTX3 levels were measured in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic streptococcae and Escherichia coli, using a commercial solid-phase enzyme-linked immunosorbent assay (ELISA). Values were measured on days 1-4 after positive blood culture, on day 13-18 and on recovery.<h4>Results</h4>The maximum PTX3 values on days 1-4 were markedly higher in nonsurvivors compared to survivors (44.8 vs 6.4 ng/ml, p<0.001) and the AUC(ROC) in the prediction of case fatality was 0.82 (95% CI 0.73-0.91). PTX3 at a cut-off level of 15 ng/ml showed 72% sensitivity and 81% specificity for fatal disease. High PTX3 (>15 ng/ml) was associated with hypotension (MAP <70 mmHg)(OR 7.9;95% CI 3.3-19.0) and high SOFA score (≥4)(OR 13.2; 95% CI 4.9-35.4). The CRP level (maximum value on days 1 to 4) did not predict case fatality at any cut-off level in the ROC curve (p = 0.132). High PTX3 (>15 ng/ml) remained an independent risk factor for case fatality in a logistic regression model adjusted for potential confounders.<h4>Conclusions</h4>PTX3 proved to be a specific independent prognostic biomarker in bacteremia. PTX3 during the first days after diagnosis showed better prognostic value as compared to CRP, a widely used biomarker in clinical settings. PTX3 measurement offers a novel opportunity for the prognostic stratification of bacteremia patients.
format	article
author	Reetta Huttunen Mikko Hurme Janne Aittoniemi Heini Huhtala Risto Vuento Janne Laine Juulia Jylhävä Jaana Syrjänen
author_facet	Reetta Huttunen Mikko Hurme Janne Aittoniemi Heini Huhtala Risto Vuento Janne Laine Juulia Jylhävä Jaana Syrjänen
author_sort	Reetta Huttunen
title	High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
title_short	High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
title_full	High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
title_fullStr	High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
title_full_unstemmed	High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
title_sort	high plasma level of long pentraxin 3 (ptx3) is associated with fatal disease in bacteremic patients: a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/68a94f0c37fd4d5a9280aef20eafd170
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High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.

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