Skip to main content

PSP is a promising biomarker of sepsis; however, potential elimination by RRT must be considered

The Original Article was published on 08 April 2022

According to Lopez et al. pancreatic stone protein (PSP) is “a promising biomarker to diagnose infections in hospitalized patients,” distinguishing infections from non-infections and outperforming C-reactive protein (CRP) and procalcitonin (PCT) [1]. PSP is a 16 kDa C-type lectin protein [1]. In patients admitted for sepsis, the value of PSP at admission correlates with the Sequential Organ Failure Assessment (SOFA) score and can predict intensive care unit (ICU) mortality [1]. Lopez et al. based most of their findings on a study looking at 90 severe patients in a burn ICU [2]. Septic shock induced acute kidney injury (AKI) in at least 50% and 25% needed continuous renal replacement therapy (CRRT) [3]. However, looking at the molecular weight of PSP, we do need to consider potential elimination by RRT using membranes with a cut off of 35–40 kDa [4]. New highly adsorptive membranes (HAM) could also absorb PSP in addition to the removal by convection [5]. Since the risk of elimination by CRRT is very likely, PSP is potentially unreliable for predicting either septic shock or patients needing to be transferred to the ICU. Before analyzing the accuracy of PSP studies are needed to determine if PSP is significantly eliminated or not by CRRT.

Availability of data and materials

Not applicable.

Abbreviations

PSP:

Pancreatic stone protein

CRP:

C reactive protein

PCT:

Procalcitonin

SOFA:

Sequential organ failure assessment

ICU:

Intensive care unit

AKI:

Acute kidney injury

CRRT:

Continuous renal replacement therapy

HAM:

High adsorptive membranes

References

  1. Lopes D, Chumbinho B, Bandovas JP, et al. Pancreatic stone protein as a biomarker of sepsis. Crit Care. 2022;26(1):100. https://doi.org/10.1186/s13054-022-03953-x.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Klein H, Niggemann P, Buehler P, et al. Pancreatic stone protein predicts sepsis in severely burned patients irrespective of trauma severity. Ann Surg. 2021;274(6):e1179–86. https://doi.org/10.1097/SLA.0000000000003784.

    Article  PubMed  Google Scholar 

  3. Peters E, Antonelli M, Wittebole X, et al. A worldwide multicentre evaluation of the influence of deterioration or improvement of acute kidney injury on clinical outcome in critically ill patients with and without sepsis at ICU admission: results from The Intensive Care Over Nations audit. Crit Care. 2018;22(1):188. https://doi.org/10.1186/s13054-018-2112-z.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Honore PM, Redant S, De Bels D. Reliability of biomarkers of sepsis during extracorporeal therapies: the clinician needs to know what is eliminated and what is not. Crit Care. 2020;24(1):553. https://doi.org/10.1186/s13054-020-03277-8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Honore PM, Spapen HD. What a clinician should know about a renal replacement membrane? J Transl Int Med. 2018;6(2):62–5. https://doi.org/10.2478/jtim-2018-0016.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

None.

Funding

None.

Author information

Authors and Affiliations

Authors

Contributions

PMH, RA designed the paper. PMH, SR, PD, SB, IB, EP, TP, BVC, KK, LBG, SA, AG, RA participated in drafting and reviewing. PMH, SR, PD, SB, IB, EP, TP, BVC, KK, LBG, SA, AG, RA read and approved the final version of the manuscript.

Corresponding author

Correspondence to Patrick M. Honore.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare to have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Honore, P.M., Redant, S., Djimafo, P. et al. PSP is a promising biomarker of sepsis; however, potential elimination by RRT must be considered. Crit Care 26, 342 (2022). https://doi.org/10.1186/s13054-022-04214-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13054-022-04214-7