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Published on: April 19, 2017
Soluble intercellular adhesion molecule (ICAM)-1 detects invasive fungal infections in patients following liver
Sebastian O Decker1, Anne Incamps2, Henryk Wilk1
1Department of Anesthesiology, Heidelberg University Hospital, , Heidelberg, Germany.
Purpose:
Despite antifungal prophylaxis, liver transplanted patients are endangered by invasive fungal infections (IFI). Routinely used microbiological procedures are hallmarked by significant weaknesses, which may lead to a delay in antifungal treatment.
Methods:
Culture-based fungal findings, routinely used biomarkers of infection/inflammation (e.g., procalcitonin or C-reactive protein), as well as corresponding plasma concentrations of soluble Intercellular Adhesion Molecule (ICAM)-1 were analysed in 93 patients during a period of 28 days following liver transplantation (LTX).
Results:
Plasmatic sICAM-1 was significantly elevated in patients affected by an IFI within the first 28 days in comparison to fungally colonised or unobtrusive LTX patients. sICAM-1 might therefore be helpful for the identification of IFI patients after LTX (e.g., Receiver Operating Characteristic (ROC)-Area Under the Curve (AUC): 0.714 at 14d after LTX). The diagnostic performance of sICAM-1 was further improved by its combined use with different other IFI biomarkers (e.g., midregional proadrenomedullin).
Conclusion:
The diagnostic deficiencies of routinely used microbiological procedures for IFI detection in patients after LTX may be reduced by plasmatic sICAM-1 measurements. Clinical Trial Notation. German Clinical Trials Register: DRKS00005480.
Insights
Soluble Intercellular Adhesion Molecule (sICAM)-1 shows promise for early detection of invasive fungal infections (IFI) in liver transplant patients, improving upon current methods. This biomarker aids in timely antifungal treatment for better outcomes.
Area of Science:
- Transplantation immunology
- Infectious diseases
- Biomarker discovery
Background:
- Liver transplant recipients face high risks of invasive fungal infections (IFI) despite antifungal prophylaxis.
- Current diagnostic methods for IFI often have limitations, potentially delaying crucial antifungal therapy.
Purpose of the Study:
- To evaluate the diagnostic utility of plasma soluble Intercellular Adhesion Molecule (sICAM)-1 for identifying IFI in liver transplant patients.
- To compare the performance of sICAM-1 with conventional infection/inflammation biomarkers.
Main Methods:
- Analysis of plasma sICAM-1 concentrations in 93 liver transplant patients within 28 days post-transplant.
- Comparison of sICAM-1 levels between patients with IFI, fungal colonization, and no fungal presence.
- Assessment of diagnostic performance using Receiver Operating Characteristic (ROC) analysis, including combined use with other biomarkers.
Main Results:
- Significantly elevated sICAM-1 levels were observed in patients with IFI compared to non-IFI patients.
- sICAM-1 demonstrated potential for IFI identification (ROC-AUC: 0.714 at 14 days post-LTX).
- Combined use of sICAM-1 with biomarkers like midregional proadrenomedullin enhanced diagnostic accuracy.
Conclusions:
- Plasma sICAM-1 measurement can help overcome diagnostic limitations of standard microbiological procedures for IFI detection in liver transplant recipients.
- sICAM-1 represents a promising biomarker for early IFI diagnosis, potentially improving treatment initiation and patient outcomes.
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