Analysis of some sepsis markers: C-reactive protein, Procalcitonin, Osteopontin and suPAR

Sepsis appears to be due to an uncontrolled pro and anti-inflammatory response leading to organ dysfunction until shock and death.Accuracy of diagnosis and appropriate treatment affect the outcome. Aim of the study was to investigate if the levels of Osteopontin (OPN) and Soluble Urokinase-type Plasminoge Activator Receptor (suPAR) might be early markers of sepsis and if these markers play a role in predicting the progression to septic shock. Methods:The levels of OPN, suPAR, C-reactive protein (CRP) and procalcitonin (PCT) were measured in patients at higher risk of infection. The samples were collected from the day of admission for the following fifteenth day. During recovery Sistemic Inflammatory Response Syndrome (SIRS) criteria, blood chemistry data, blood gas- analysis, lactate and diuresis were collected. Microbiological culture were performed according to the clinical condition. Results: 29 patients were enrolled in the study, including 14 subjects with positive blood cultures.The values of OPN, PCT, suPAR and CRP were significantly increased in patients with positive blood cultures than those with negative blood cultures.Analysing changes of the levels of OPN, suPAR, PCT and CRP in patients with septic shock, the values of OPN increased in advance to the clinical diagnosis of septic shock, while the values of suPAR and PCT slight delay compared to those OPN.The levels of CRP were independent from the onset of septic shock state. Conclusions: These preliminary data suggest that Osteopontin and suPAR can be used as early markers of sepsis and might be useful in monitoring of septic outcome to predict a possible evolution to septic shock.