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A Clinical Diagnostic Study: Fibulin-2 is a Novel Promising Biomarker for Predicting Infection
Shidan Li1, Hao Jiang2, Wei Xing3
1Department of Orthopaedics, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, People's Republic of China.
Introduction:
Infection remains a major cause of morbidity and mortality in hospital. As uncontrolled early infection may develop into systemic infection and eventually progress to sepsis, it is important to address infection at an early stage. Furthermore, early detection and prompt diagnosis of infection are the basis of clinical intervention. However, as a result of the interference of complex aetiologies, including fever and trauma, problems regarding the sensitivity and specificity of current diagnostic indices remain, such as for C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBC), neutrophil ratio (NEU%), interleukin-6 (IL-6) and D-dimer. As a result, there is an urgent need to develop new biomarkers to diagnose infection.
Methods:
From January to October 2021, consecutive patients in the emergency department (ED) were recruited to investigate the feasibility of fibulin-2 as a diagnostic indicator of early infection. Fibulin-2 concentrations in plasma were determined with enzyme-linked immunosorbent assay (ELISA). The performance of fibulin-2 for predicting infection was analysed by receiver operating characteristic (ROC) curves.
Results:
We found that the plasma fibulin-2 level was elevated in patients with infection compared with those without infection. ROC curve analysis showed that the area under the curve (AUC) for fibulin-2 was 0.712. For all patients included, the diagnostic ability of fibulin-2 (AUC 0.712) performed as well as CRP (AUC 0.667) and PCT (AUC 0.632), and better than WBC (AUC 0.620), NEU% (AUC 0.619), IL-6 (AUC 0.561) and D-dimer (AUC 0.630). In patients with fever, fibulin-2 performed as well as PCT and better than the other biomarkers in infection diagnosis. In particular, fibulin-2 performed better than all these biomarkers in patients with trauma.
Conclusion:
Fibulin-2 is a novel promising diagnostic biomarker for predicting infection.
Insights
Fibulin-2 shows promise as a novel biomarker for early infection detection. This new marker performed comparably to established tests like CRP and PCT, and better in specific patient groups.
Area of Science:
- Biomarker discovery
- Infectious disease diagnostics
- Clinical chemistry
Background:
- Infection is a leading cause of hospital morbidity and mortality.
- Early detection and diagnosis of infection are crucial for timely clinical intervention.
- Current diagnostic markers like CRP, PCT, and WBC have limitations in sensitivity and specificity, especially with confounding factors like fever and trauma.
Purpose of the Study:
- To investigate the potential of fibulin-2 as a diagnostic indicator for early infection.
- To evaluate the diagnostic performance of fibulin-2 compared to existing biomarkers.
Main Methods:
- Plasma fibulin-2 concentrations were measured using enzyme-linked immunosorbent assay (ELISA) in emergency department patients.
- Receiver operating characteristic (ROC) curve analysis was employed to assess the diagnostic accuracy of fibulin-2.
Main Results:
- Plasma fibulin-2 levels were significantly elevated in patients with infection.
- Fibulin-2 demonstrated good diagnostic ability (AUC 0.712), outperforming WBC, NEU%, IL-6, and D-dimer, and performing comparably to CRP and PCT.
- Fibulin-2 showed superior performance in diagnosing infection in patients with trauma and performed well in patients with fever.
Conclusions:
- Fibulin-2 is identified as a novel and promising biomarker for predicting infection.
- Fibulin-2 offers a potential improvement in early infection diagnostics, particularly in complex cases involving trauma.
