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Normal values for pancreatic stone protein in different age groups
Luregn J Schlapbach1,2,3, Eric Giannoni4,5, Sven Wellmann6
1Mater Research Institute, Paediatric Critical Care Research Group, University of Queensland, Brisbane, Australia. l.schlapbach@uq.edu.au.
Insights
Pancreatic stone protein (PSP) levels increase with age from birth through childhood. This study establishes age-specific reference values for PSP, crucial for future sepsis trials.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Chemistry
Background:
- Pancreatic stone protein (PSP) is a potential sepsis biomarker in all age groups.
- Population-based reference values for PSP are currently lacking.
- Establishing these values is essential for accurate clinical interpretation.
Purpose of the Study:
- To determine age-specific reference values for pancreatic stone protein (PSP).
- To establish normal ranges for PSP across different pediatric age groups.
- To provide a foundation for future clinical trials utilizing PSP as a biomarker.
Main Methods:
- PSP concentrations were measured using enzyme-linked immunosorbent assay (ELISA).
- Serum samples from 372 healthy individuals (neonates, children, adults) were analyzed.
- The adjacent categories method identified significant differences in PSP levels between age groups.
Main Results:
- PSP levels showed no gender dependency, with a median of 9.2 ng/ml.
- A significant age-dependent increase in PSP was observed from birth to childhood (p < 0.001).
- PSP levels were higher on postnatal day three and showed good agreement between capillary and venous samples.
Conclusions:
- This study successfully established age-specific normal values for PSP.
- The findings support the use of PSP as a biomarker across different age groups.
- These reference values will aid in defining cut-offs for future sepsis diagnostic trials.
Background:
Pancreatic stone protein (PSP) has been identified as a promising sepsis marker in adults, children and neonates. However, data on population-based reference values are lacking. This study aimed to establish age-specific reference values for PSP.
Methods:
PSP was determined using a specific ELISA. PSP serum concentrations were determined in 372 healthy subjects including 217 neonates, 94 infants and children up to 16 years, and 61 adults. The adjacent categories method was used to determine which age categories had significantly different PSP concentrations.
Results:
PSP circulating levels were not gender-dependent and ranged from 1.0 to 99.4 ng/ml with a median of 9.2 ng/ml. PSP increased significantly between the age categories, from a median of 2.6 ng/ml in very preterm newborns, to 6.3 ng/ml in term newborns, to 16.1 ng/ml in older children (p < 0.001). PSP levels were higher on postnatal day three compared to levels measured immediately post delivery (p < 0.001). Paired umbilical artery and umbilical vein samples were strongly correlated (p < 0.001). Simultaneously obtained capillary heel-prick versus venous samples showed a good level of agreement for PSP (Rho 0.89, bias 19 %).
Conclusions:
This study provides age-specific normal values that may be used to define cut-offs for future trials on PSP. We demonstrate an age-dependent increase of PSP from birth to childhood.
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