Critical Care
© BioMed Central Ltd 2004
10.1186/cc2658

New diagnostic marker for sepsis: soluble CD14 subtype

K Shirakawa1, S Furusako1, S Endo2, Y Yaegashi2 and H Inada2
(1)
Mochida Pharmaceutical Co., Ltd, Gotemba, Shizuoka, Japan
(2)
Iwate Medical University, Morioka, Japan
 
Published online: 15 March 2004
Without Abstract

Introduction

Accurate and timely diagnosis of sepsis is essential for the treatment of the early infected patients of systemic inflammatory response syndrome (SIRS). But current diagnostic methods for early detection and for detection of the severity of sepsis have low sensitivity and poor specificity. This study aimed to develop a new diagnostic marker, serum soluble CD14 subtype(sCD14-ST), which was first discovered as a small molecular weight of CD14 specific for sepsis.

Methods

A small molecular weight of CD14 was discovered by a new type of soluble CD14 ELISA, which was developed with two types of anti-CD14 antibodies and evaluated using serum samples of patient with sepsis, SIRS, other diseases and healthy control. At the same time, the determination of the C-reactive protein, endotoxin, soluble CD14 (IBL-Hamburg), procalcitonin (PCT) (BRAHMS) and SOFA scoring were also carried.

Results

The new assay detected the small molecular weight of CD14 specifically, but not the 49 kDa and 55 kDa soluble CD14 in serum. The concentration of normal controls (71 specimens) was 27.4 ± 14.4 (mean ± SD) ng/ml and the cutoff level was established at 57 ng/ml (mean ± 2SD). The ELISA detected 94.5% (52/55) of sepsis and 16.3% (13/80) of SIRS. The mean concentration of sepsis and SIRS was 248.2 ng/ml and 41.4 ng/ml, respectively. Sequential study of sCD14-ST was a significant association with the SOFA score and serum endotoxin level. Serum sCD14-ST increased in the very early phase of infection, and was detected much faster and easier than the blood culture test. The new assay was not correlated to soluble CD14 (IBL-Hamburg) and PCT (BRAHMS).

Conclusion

This ELISA can detect specifically for sepsis during the early phase of infection and is useful for monitoring the severity of sepsis. The small molecular sCD14-ST is a new marker for diagnosing sepsis.