Review article
Pathobiochemistry and clinical use of procalcitonin
Michael Meisner *
Department of Anesthesiology and Intensive Care Medicine,University of Jena,Bachstr 18,D-07743Jena,Germany
Received 14November 2001;received in revised form 22March 2002;accepted 25March 2002
Abstract
Induction of the protein procalcitonin during infection and inflammation was first described approximately 10years ago.A large number of publications,primarily clinical studies,demonstrate the increasing use of procalcitonin in modern clinical practice.However,data on the biological function and origin of procalcitonin is scarce.Findings regarding the possible role and source of procalcitonin in sepsis and infection were recently published,and the pathophysiology of the protein has meanwhile been investigated in various experimental models.Procalcitonin obviously has certain biological functions,and it is also known to be specifically induced.Given the hormonal origin of the mature protein and the inflammation-related functions of its propeptides,some investigators suggest that procalcitonin should be referred to as a ‘‘hormokine,’’although its biological functions should be studied in more detail.This review will survey the data now available in recent publications on the induction,production sources,possible biological functions and clinical uses of procalcitonin.D 2002Elsevier Science B.V .All rights reserved.
Keywords:Sepsis;Inflammation;Infection;Genetics;Biochemical;Metabolism;Calcitonin
1.Introduction
Procalcitonin (PCT)was
first described as a sepsis-induced protein detectable in the plasma of patients with sepsis and infection in the early 1990s [1].Preliminary reports indicated that PCT is mainly induced during severe systemic inflammation caused by bacterial infections,but that PCT concentrations remain low during other types of inflammation (e.g.,viral infections,autoimmune diseases,organ transplant rejection).This was soon confirmed by later studies.The most commonly determined calcitonin precur-sor molecule fragments,procalcitonin (PCT)and its
calcitonin–katacalcin fragments are measured using commercially available assays (BRAHMS,Hennigs-dorf,Germany).These assays use antibodies that bind to the calcitonin–katacalcin amino acid chain of the molecule.In addition to its induction during sepsis and infection,experimental and clinical data also indicate that PCT can be induced by a variety of stimuli including bacterial endotoxins,proinflamma-tory cytokines and triggering events such as trauma or cardiogenic shock.However,the PCT concentration remains low when an infection does not lead to a systemic inflammatory response.Numerous studies clearly demonstrate that PCT is preferentially induced in patients with sepsis,especially in severe sepsis or septic shock,and that patients with systemic inflam-mation of nonbacterial origin generally have low PCT levels.
0009-8981/02/$-see front matter D 2002Elsevier Science B.V .All rights reserved.PII:S 0009-8981(02)00101-8
*
Tel.:+49-3641-933-041;fax:+49-3641-933-256.
E-mail address:michael.meisner@t-online.de (M.Meisner).
/locate/clinchim
Clinica Chimica Acta 323(2002)17–29
