Irish Journal of Medical Science (1971 -)

, Volume 184, Issue 3, pp 597–605 | Cite as

Procalcitonin: present and future

  • H. H. LiuEmail author
  • J. B. Guo
  • Y. Geng
  • L. Su
Review Article


Critically ill patients are frequently at risk of sepsis or inflammatory conditions. Procalcitonin (PCT) is a biomarker for critically ill patients to differentiate sepsis from non-infectious triggers of the systemic inflammatory response syndrome. It has been recently shown that PCT is a valuable tool to guide antibiotic treatment in patients with bacteria infections. However, PCT is also less than a universal and perfect biomarker, and its physiologic role remains unknown. An increase in PCT is associated not only with localized bacterial infection, but also with non-infectious disease or other microbial infections. Numerous studies have suggested that use of PCT would reduce patients’ exposure to antibiotics; however, the use of PCT-guided management of antibiotics strategy needs further study to validate their safety in daily practice in ICU settings. Data supporting this concept from randomized trials are still required. Future studies should focus on PCT kinetics. On the other hand, the need for biologic role of PCT shall be highlighted. Immunoneutralization of PCT will likely be a therapeutic approach for human sepsis only if its physiologic effects are elaborated. The aim of this review is to summarize and discuss the current evidence for PCT in a series of clinical settings.


Procalcitonin Microbial infections Sepsis Antibiotics 





The systemic inflammatory response syndrome






N-Procalcitonin part


CT carboxyl terminal peptide


C-reactive protein


Community acquired pneumonia


Intensive care units


Community acquired pneumonia


Calcitonin gene-related peptide


Matrix-assisted laser desorption/ ionization time of flight mass spectrometry


Medullary thyroid carcinoma




Conflict of interest



  1. 1.
    O’Brien DJ, Gould IM (2013) Maximizing the impact of antimicrobial stewardship: the role of diagnostics, national and international efforts. Curr Opin Infect Dis 26(4):352–358. doi: 10.1097/QCO.0b013e3283631046 CrossRefPubMedGoogle Scholar
  2. 2.
    Uzzan B, Cohen R, Nicolas P et al (2006) Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 34(7):1996–2003. doi: 10.1097/01.CCM.0000226413.54364.36 CrossRefPubMedGoogle Scholar
  3. 3.
    Schuetz P, Albrich W, Mueller B (2011) Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med 9:107. doi: 10.1186/1741-7015-9-107 PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Albrich WC, Dusemund F, Bucher B et al (2012) Effectiveness and safety of procalcitonin-guided antibiotic therapy in lower respiratory tract infections in “real life”: an international, multicenter poststudy survey (ProREAL). Arch Intern Med 172(9):715–722. doi: 10.1001/archinternmed.2012.770 CrossRefPubMedGoogle Scholar
  5. 5.
    Al-Nakeeb S, Clermont G (2005) Procalcitonin testing has the potential to reduce unnecessary antibiotic use in patients with suspected lower respiratory tract infections. Crit Care 9(3):E5. doi: 10.1186/cc3496 PubMedCentralCrossRefGoogle Scholar
  6. 6.
    Briel M, Schuetz P, Mueller B et al (2008) Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Arch Intern Med 168(18):2000–2007. doi: 10.1001/archinte.168.18.2000 discussion 2007–2008 CrossRefPubMedGoogle Scholar
  7. 7.
    Moya F, Nieto A, R-Candela JL (1975) Calcitonin biosynthesis: evidence for a precursor. Eur J Biochem FEBS 55 (2):407–413Google Scholar
  8. 8.
    Jacobs JW, Goodman RH, Chin WW et al (1981) Calcitonin messenger RNA encodes multiple polypeptides in a single precursor. Science 213(4506):457–459CrossRefPubMedGoogle Scholar
  9. 9.
    Becker KL, Nylen ES, White JC et al (2004) Clinical review 167: procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors. J Clin Endocrinol Metab 89(4):1512–1525. doi: 10.1210/jc.2002-021444 CrossRefPubMedGoogle Scholar
  10. 10.
    Gilbert DN (2011) Procalcitonin as a biomarker in respiratory tract infection. Clin Infect Dis Off Publ Infect Dis Soc Am 52(Suppl 4):S346–S350. doi: 10.1093/cid/cir050 CrossRefGoogle Scholar
  11. 11.
    Morgenthaler NG, Struck J, Fischer-Schulz C et al (2002) Sensitive immunoluminometric assay for the detection of procalcitonin. Clin Chem 48(5):788–790PubMedGoogle Scholar
  12. 12.
    Becker KL, Snider R, Nylen ES (2008) Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations. Crit Care Med 36(3):941–952. doi: 10.1097/CCM.0B013E318165BABB CrossRefPubMedGoogle Scholar
  13. 13.
    Niederman MS (2008) Biological markers to determine eligibility in trials for community-acquired pneumonia: a focus on procalcitonin. Clin Infect Dis Off Publ Infect Dis Soc Am 47(Suppl 3):S127–S132. doi: 10.1086/591393 CrossRefGoogle Scholar
  14. 14.
    Steinbach G, Rau B, Debard AL et al (2004) Multicenter evaluation of a new immunoassay for procalcitonin measurement on the Kryptor System. Clin Chem Lab Med CCLM/FESCC 42(4):440–449. doi: 10.1515/cclm.2004.077 Google Scholar
  15. 15.
    Menendez R, Martinez R, Reyes S et al (2009) Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia. Thorax 64(7):587–591. doi: 10.1136/thx.2008.105312 CrossRefPubMedGoogle Scholar
  16. 16.
    Muller B, White JC, Nylen ES et al (2001) Ubiquitous expression of the calcitonin-i gene in multiple tissues in response to sepsis. J Clin Endocrinol Metab 86(1):396–404PubMedGoogle Scholar
  17. 17.
    Linscheid P, Seboek D, Nylen ES et al (2003) In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue. Endocrinology 144(12):5578–5584. doi: 10.1210/en.2003-0854 CrossRefPubMedGoogle Scholar
  18. 18.
    Dandona P, Nix D, Wilson MF et al (1994) Procalcitonin increase after endotoxin injection in normal subjects. J Clin Endocrinol Metab 79(6):1605–1608. doi: 10.1210/jcem.79.6.7989463 PubMedGoogle Scholar
  19. 19.
    Sylvie Opatrná, Jan Klaboch, Karel Opatrný Jr et al (2005) Procalcitonin levels in peritoneal dialysis patients. Perit Dial Int (25):470–472Google Scholar
  20. 20.
    Preas HL 2nd, Nylen ES, Snider RH et al (2001) Effects of anti-inflammatory agents on serum levels of calcitonin precursors during human experimental endotoxemia. J Infect Dis 184:373–376CrossRefPubMedGoogle Scholar
  21. 21.
    Kapoor S (2009) Procalcitonin and its utility as a diagnostic and prognostic assay in patients with renal dysfunction and immunosuppressive conditions. J Infect Chemother Off J Jpn Soc Chemother 15(1):58. doi: 10.1007/s10156-008-0650-z author reply 59 CrossRefGoogle Scholar
  22. 22.
    Amour J, Birenbaum A, Langeron O et al (2008) Influence of renal dysfunction on the accuracy of procalcitonin for the diagnosis of postoperative infection after vascular surgery. Crit Care Med 36(4):1147–1154. doi: 10.1097/CCM.0b013e3181692966 CrossRefPubMedGoogle Scholar
  23. 23.
    Li HX, Liu ZM, Zhao SJ et al (2014) Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients. J Int Med Res 42(4):1050–1059. doi: 10.1177/0300060514528483 CrossRefPubMedGoogle Scholar
  24. 24.
    Lin KH, Wang FL, Wu MS et al (2014) Serum procalcitonin and C-reactive protein levels as markers of bacterial infection in patients with liver cirrhosis: a systematic review and meta-analysis. Diagn Microbiol Infect Dis 80(1):72–78. doi: 10.1016/j.diagmicrobio.2014.03.029 CrossRefPubMedGoogle Scholar
  25. 25.
    van der Starre WE, Zunder SM, Vollaard AM et al (2014) Prognostic value of pro-adrenomedullin, procalcitonin and C-reactive protein in predicting outcome of febrile urinary tract infection. Clin Microbiol Infect. doi: 10.1111/1469-0691.12645
  26. 26.
    Meisner M, Tschaikowsky K, Palmaers T et al (1999) Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS. Crit Care 3(1):45–50. doi: 10.1186/cc306 PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    Luzzani A, Polati E, Dorizzi R et al (2003) Comparison of procalcitonin and C-reactive protein as markers of sepsis. Crit Care Med 31(6):1737–1741. doi: 10.1097/01.CCM.0000063440.19188.ED CrossRefPubMedGoogle Scholar
  28. 28.
    Simon L, Gauvin F, Amre DK et al (2004) Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis Off Publ Infectious Dis Soc Am 39(2):206–217. doi: 10.1086/421997 CrossRefGoogle Scholar
  29. 29.
    Oliveira CF, Botoni FA, Oliveira CR et al (2013) Procalcitonin versus C-reactive protein for guiding antibiotic therapy in sepsis: a randomized trial. Crit Care Med 41(10):2336–2343. doi: 10.1097/CCM.0b013e31828e969f CrossRefPubMedGoogle Scholar
  30. 30.
    Gaini S, Koldkjaer OG, Pedersen C et al (2006) Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis: a prospective study. Crit Care 10(2):R53. doi: 10.1186/cc4866 PubMedCentralCrossRefPubMedGoogle Scholar
  31. 31.
    Watkin RW, Harper LV, Vernallis AB et al (2007) Pro-inflammatory cytokines IL6, TNF-alpha, IL1beta, procalcitonin, lipopolysaccharide binding protein and C-reactive protein in infective endocarditis. J Infect 55(3):220–225. doi: 10.1016/j.jinf.2007.05.174 CrossRefPubMedGoogle Scholar
  32. 32.
    Chauveau P, Level C, Lasseur C et al (2003) C-reactive protein and procalcitonin as markers of mortality in hemodialysis patients: a 2-year prospective study. J Renal Nutr Off J Counc Renal Nutr Natl Kidney Found 13(2):137–143. doi: 10.1053/jren.2003.50017 CrossRefGoogle Scholar
  33. 33.
    van Vugt SF, Broekhuizen BD, Lammens C et al (2013) Use of serum C reactive protein and procalcitonin concentrations in addition to symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough: diagnostic study. BMJ 346:f2450. doi: 10.1136/bmj.f2450 PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Daniels JM, Schoorl M, Snijders D et al (2010) Procalcitonin vs C-reactive protein as predictive markers of response to antibiotic therapy in acute exacerbations of COPD. Chest 138(5):1108–1115. doi: 10.1378/chest.09-2927 CrossRefPubMedGoogle Scholar
  35. 35.
    Magrini L, Gagliano G, Travaglino F et al (2014) Comparison between white blood cell count, procalcitonin and C reactive protein as diagnostic and prognostic biomarkers of infection or sepsis in patients presenting to emergency department. Clin Chem Lab Med 52(10):1465–1472. doi: 10.1515/cclm-2014-0210 CrossRefPubMedGoogle Scholar
  36. 36.
    Sanchez-Yepes M, Aznar-Oroval E, Lorente-Alegre P et al (2014) Use of procalcitonin and C-reactive protein as infection markers in febrile neutropenic patients undergoing haematopoietic stem cell transplant. Enferm Infecc Microbiol Clin 32(7):418–423. doi: 10.1016/j.eimc.2013.09.003 CrossRefPubMedGoogle Scholar
  37. 37.
    Macrina F, Tritapepe L, Pompei F et al (2005) Procalcitonin is useful whereas C-reactive protein is not, to predict complications following coronary artery bypass surgery. Perfusion 20(3):169–175CrossRefPubMedGoogle Scholar
  38. 38.
    Nikfar R, Khotaee G, Ataee N et al (2010) Usefulness of procalcitonin rapid test for the diagnosis of acute pyelonephritis in children in the emergency department. Pediatr Int 52(2):196–198. doi: 10.1111/j.1442-200X.2009.002917.x CrossRefPubMedGoogle Scholar
  39. 39.
    Mofidi RSS, Patil PV, Ogston S et al (2009) The value of procalcitonin at predicting the severity of acute pancreatitis and development of infected pancreatic necrosis: systematic review. Surgery 146(1):72–81. doi: 10.1016/j.surg.2009.02.013 CrossRefPubMedGoogle Scholar
  40. 40.
    Yousif M, El-Helbawy R, HaE-H AmrDarwish (2012) Usefulness of procalcitonin as a diagnostic marker of pleural effusion. J Am Sci 8:7Google Scholar
  41. 41.
    Shen CJ, Wu MS, Lin KH et al (2013) The use of procalcitonin in the diagnosis of bone and joint infection: a systemic review and meta-analysis. Eur J Clin Microbiol Infect Dis 32(6):807–814. doi: 10.1007/s10096-012-1812-6 CrossRefPubMedGoogle Scholar
  42. 42.
    Sakr Y, Sponholz C, Tuche F et al (2008) The role of procalcitonin in febrile neutropenic patients: review of the literature. Infection 36(5):396–407. doi: 10.1007/s15010-008-7374-y CrossRefPubMedGoogle Scholar
  43. 43.
    Shi Y, Zhang HM, Liu Y et al (2012) The value of procalcitonin for diagnosing infection in critically ill patients receiving long-term immunosuppressive therapy. Zhonghua nei ke za zhi 51(3):192–196PubMedGoogle Scholar
  44. 44.
    Ingram PR, Inglis T, Moxon D et al (2010) Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection. Intensive Care Med 36(3):528–532. doi: 10.1007/s00134-009-1746-3 CrossRefPubMedGoogle Scholar
  45. 45.
    Uzzan B, Izri A, Durand R, Deniau M, Bouchaud O, Perret GY (2006) Serum procalcitonin in uncomplicated falciparum malaria: a preliminary study. Travel Med Infect Dis 4(2):77–80. doi: 10.1016/j.tmaid.2005.04.003 CrossRefPubMedGoogle Scholar
  46. 46.
    Hollenstein U, Looareesuwan S, Aichelburg A et al (1998) Serum procalcitonin levels in severe Plasmodium falciparum malaria. Am J Trop Med Hyg 59(6):860–863PubMedGoogle Scholar
  47. 47.
    Oku E, Nomura K, Nakamura T et al (2012) Amebic colitis and liver abscess complicated by high serum procalcitonin in acute myeloid leukemia. Kansenshogaku zasshi 86(6):773–777CrossRefPubMedGoogle Scholar
  48. 48.
    Peter JV, Karthik G, Ramakrishna K et al (2013) Elevated procalcitonin is associated with increased mortality in patients with scrub typhus infection needing intensive care admission. Indian J Crit Care Med 17(3):174–177. doi: 10.4103/0972-5229.117063 PubMedCentralCrossRefPubMedGoogle Scholar
  49. 49.
    Reinhart K, Bauer M, Riedemann NC et al (2012) New approaches to sepsis: molecular diagnostics and biomarkers. Clin Microbiol Rev 25(4):609–634. doi: 10.1128/CMR.00016-12 PubMedCentralCrossRefPubMedGoogle Scholar
  50. 50.
    Karlsson S, Heikkinen M, Pettila V et al (2010) Predictive value of procalcitonin decrease in patients with severe sepsis: a prospective observational study. Crit Care 14(6):R205. doi: 10.1186/cc9327 PubMedCentralCrossRefPubMedGoogle Scholar
  51. 51.
    Meidani MKF, Abolghasemi H, Jamali B (2013) Procalcitonin and quantitative C-reactive protein role in the early diagnosis of sepsis in patients with febrile neutropenia. South Asian J Cancer 2(4):216–219. doi: 10.4103/2278-330x.119913 PubMedCentralCrossRefPubMedGoogle Scholar
  52. 52.
    Wacker C, Prkno A, Brunkhorst FM et al (2013) Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis. 13(5):426–435. doi: 10.1016/S1473-3099(12)70323-7 CrossRefPubMedGoogle Scholar
  53. 53.
    Afshari A, Harbarth S (2013) Procalcitonin as diagnostic biomarker of sepsis. Lancet Infect Dis. 13(5):382–384. doi: 10.1016/S1473-3099(13)70026-4 CrossRefPubMedGoogle Scholar
  54. 54.
    Broad PM, Symes AJ, Thakker RV et al (1989) Structure and methylation of the human calcitonin/alpha-CGRP gene. Nucleic Acids Res 17(17):6999–7011PubMedCentralCrossRefPubMedGoogle Scholar
  55. 55.
    Christ-Crain M, Jaccard-Stolz D, Bingisser R et al (2004) Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 363(9409):600–607. doi: 10.1016/s0140-6736(04)15591-8 CrossRefPubMedGoogle Scholar
  56. 56.
    Christ-Crain M, Stolz D, Bingisser R et al (2006) Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia. Am J Respir Crit Care Med 174(1):84–93. doi: 10.1164/rccm.200512-1922OC CrossRefPubMedGoogle Scholar
  57. 57.
    Ding J, Chen Z, Feng K (2013) Procalcitonin-guided antibiotic use in acute exacerbations of idiopathic pulmonary fibrosis. Int J Med Sci. 10(7):903–907. doi: 10.7150/ijms.4972 PubMedCentralCrossRefPubMedGoogle Scholar
  58. 58.
    Stolz DC-CM, Bingisser R, Leuppi J et al (2007) Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest 131(1):9–19. doi: 10.1378/chest.06-1500 CrossRefPubMedGoogle Scholar
  59. 59.
    Schuetz PCV, Briel M, Greenwald JL (2011) Procalcitonin algorithms for antibiotic therapy decisions: a systematic review of randomized controlled trials and recommendations for clinical algorithms. Arch Intern Med 171(15):1322–1331. doi: 10.1001/archinternmed.2011.318 CrossRefPubMedGoogle Scholar
  60. 60.
    Hochreiter M, Kohler T, Schweiger AM et al (2009) Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial. Crit Care 13(3):R83. doi: 10.1186/cc7903 PubMedCentralCrossRefPubMedGoogle Scholar
  61. 61.
    Bouadma L, Luyt CE, Tubach F et al (2010) Use of procalcitonin to reduce patients’ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial. Lancet 375(9713):463–474. doi: 10.1016/s0140-6736(09)61879-1 CrossRefPubMedGoogle Scholar
  62. 62.
    Jensen JU, Hein L, Lundgren B et al (2011) Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: a randomized trial. Crit Care Med 39(9):2048–2058. doi: 10.1097/CCM.0b013e31821e8791 CrossRefPubMedGoogle Scholar
  63. 63.
    Tang BM, Eslick GD, Craig JC, McLean AS (2007) Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis 7(3):210–217. doi: 10.1016/s1473-3099(07)70052-x CrossRefPubMedGoogle Scholar
  64. 64.
    Jones AE, Fiechtl JF, Brown MD et al (2007) Procalcitonin test in the diagnosis of bacteremia: a meta-analysis. Ann Emerg Med 50(1):34–41. doi: 10.1016/j.annemergmed.2006.10.020 CrossRefPubMedGoogle Scholar
  65. 65.
    Christ-Crain M, Muller B (2005) Procalcitonin in bacterial infections–hype, hope, more or less? Swiss Med Wkly 135(31–32):451–460 2005/31/smw-11169 PubMedGoogle Scholar
  66. 66.
    Gilbert DN (2010) Use of plasma procalcitonin levels as an adjunct to clinical microbiology. J Clin Microbiol 48(7):2325–2329. doi: 10.1128/JCM.00655-10 PubMedCentralCrossRefPubMedGoogle Scholar
  67. 67.
    Tavares E, Minano FJ (2010) Immunoneutralization of the aminoprocalcitonin peptide of procalcitonin protects rats from lethal endotoxaemia: neuroendocrine and systemic studies. Clin Sci 119(12):519–534. doi: 10.1042/CS20100007 CrossRefPubMedGoogle Scholar
  68. 68.
    Lindberg M, Hole A, Johnsen H et al (2002) Reference intervals for procalcitonin and C-reactive protein after major abdominal surgery. Scand J Clin Lab Invest 62(3):189–194CrossRefPubMedGoogle Scholar
  69. 69.
    Sexton PM, Christopoulos G, Christopoulos A et al (2008) Procalcitonin has bioactivity at calcitonin receptor family complexes: potential mediator implications in sepsis. Crit Care Med 36(5):1637–1640. doi: 10.1097/CCM.0b013e318170a554 CrossRefPubMedGoogle Scholar
  70. 70.
    Monneret G, Arpin M, Venet F et al (2003) Calcitonin gene related peptide and N-procalcitonin modulate CD11b upregulation in lipopolysaccharide activated monocytes and neutrophils. Intensive Care Med 29(6):923–928. doi: 10.1007/s00134-003-1759-2 PubMedGoogle Scholar
  71. 71.
    Araujo M, Doi SQ, Palant CE et al (2013) Procalcitonin induced cytotoxicity and apoptosis in mesangial cells: implications for septic renal injury. Inflamm Res Off J Eur Histamine Res Soc 62 (10):887–894. doi: 10.1007/s00011-013-0646-8
  72. 72.
    Liappis AP, Gibbs KW, Nylen ES et al (2011) Exogenous procalcitonin evokes a pro-inflammatory cytokine response. Inflamm Res Off J Eur Histamine Res Soc 60(2):203–207. doi: 10.1007/s00011-010-0255-8 Google Scholar
  73. 73.
    Wagner KE, Martinez JM, Vath SD et al (2002) Early immunoneutralization of calcitonin precursors attenuates the adverse physiologic response to sepsis in pigs. Crit Care Med 30(10):2313–2321. doi: 10.1097/01.CCM.0000030446.45432.43 CrossRefPubMedGoogle Scholar
  74. 74.
    Becker KL, Snider R, Nylen ES (2010) Procalcitonin in sepsis and systemic inflammation: a harmful biomarker and a therapeutic target. Br J Pharmacol 159(2):253–264. doi: 10.1111/j.1476-5381.2009.00433.x PubMedCentralCrossRefPubMedGoogle Scholar
  75. 75.
    Wolff M, Bouadma L (2010) What procalcitonin brings to management of sepsis in the ICU. Crit Care 14(6):1007. doi: 10.1186/cc9330 PubMedCentralCrossRefPubMedGoogle Scholar
  76. 76.
    Radimerski TM, Grisouard J, Timper K et al (2011) Role of calcium in lipopolysaccharide-induced calcitonin gene expression in human adipocytes. Innate Immun 17(4):403–413. doi: 10.1177/1753425910377100 CrossRefPubMedGoogle Scholar
  77. 77.
    Zannoni A, Giunti M, Bernardini C et al (2012) Procalcitonin gene expression after LPS stimulation in the porcine animal model. Res Vet Sci 93(2012):921–927. doi: 10.1016/j.rvsc.2011.09.011 CrossRefPubMedGoogle Scholar
  78. 78.
    Oberhoffer M, Stonans I, Russwurm S (1999) Procalcitonin expression in human peripheral blood mononuclear cells and its modulation by lipopolysaccharides and sepsis-related cytokines in vitro. J Lab Clin Med 134:49–55Google Scholar
  79. 79.
    Giunti M, Peli A, Battilani M (2010) Evaluation of CALC-I gene (CALCA) expression in tissues of dogs with signs of the systemic inflammatory response syndrome. J Vet Emerg Crit Care (San Antonio) 20(5):523–527. doi: 10.1111/j.1476-4431.2010.00575.x CrossRefGoogle Scholar
  80. 80.
    Russwurm S, Stonans I, Stonane E et al (2001) Procalcitonin and CGRP-I mRNA expression in various human tissues. Shock 16(2):109–112CrossRefPubMedGoogle Scholar
  81. 81.
    Kuzi S, Aroch I, Peleg K et al (2008) Canine procalcitonin messenger RNA expression. J Vet Diagn Invest 20(5):629–633. doi: 10.1177/104063870802000516 CrossRefPubMedGoogle Scholar
  82. 82.
    Monneret G, Laroche B, Bienvenu J (1999) Procalcitonin is not produced by circulating blood cells. Infection 27(1):34–35CrossRefPubMedGoogle Scholar
  83. 83.
    Snider RH Jr, Nylen ES, Becker KL (1997) Procalcitonin and its component peptides in systemic inflammation: immunochemical characterization. J Investig Med 45(9):552–560PubMedGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2015

Authors and Affiliations

  1. 1.Department of Emergency, Zhongshan HospitalXiamen UniversityXiamenChina
  2. 2.General Surgery DepartmentHaicang HospitalXiamenChina
  3. 3.Department of Intensive Care UnitGeneral Hospital of Guangzhou Military CommandGuangzhouChina

Personalised recommendations