American Journal of Medical and Biological Research, 2014, Vol. 2, No. 4, 97-100 Available online at http://pubs.sciepub.com/ajmbr/2/4/3 © Science and Education Publishing DOI:10.12691/ajmbr-2-4-3 Presepsin: A Novel and Potential Diagnostic Biomarker for Sepsis K V Ramana 1,* , Venkata BharatKumar Pinnelli 2 , Sabitha Kandi 3 , Asha G 2 , Jayashankar CA 4 , Bhanuprakash 5 , Raghavendra DS 2 , Sanjeev D rao 1 1 Department of Microbiology, Prathima Institute of Medical sciences, Karimnagar, India 2 Department of Biochemistry, Vydehi Institute of Medical sciences and Research center, Bengaluru, India 3 Department of Biochemistry, Chalmeda Anandarao Institute of Medical sciences, Karimnagar, India 4 Department of General Medicine, Vydehi Institute of Medical sciences and Research center, Bengaluru, India 5 Department of Dermatology, Vydehi Institute of Medical sciences and Research center, Bengaluru, India *Corresponding author: ramana_20021@rediffmail.com Received August 15, 2014; Revised October 14, 2014; Accepted October 19, 2014 Abstract Sepsis is a potential clinical condition which is a consequence of infectious disease or a severe inflammatory reaction secondary to infection or injury. Sepsis in Greek means putrefaction or decay, correlating well with the multiple organ failure and severe shock resulting in death of the patient suffering from severe sepsis. Clinical management of sepsis requires prompt laboratory diagnosis and formulation of effective patient management strategies that may include antimicrobial chemotherapy in case of sepsis induced by infectious microbe. Although many laboratory biomarkers are available for the diagnosis of sepsis, only few markers have proven to be beneficial in differentiating infectious disease sepsis and sepsis of non-infectious origin. Of the available markers only few have prognostic value. We in this review discuss the utility of a novel and emerging sepsis marker, the presepsin which has a better diagnostic and prognostic value, and has been effective in predicting the survival of the sepsis patients. Keywords: presepsin, sepsis marker, management of sepsis Cite This Article: K V Ramana, Venkata BharatKumar Pinnelli, Sabitha Kandi, Asha G, Jayashankar CA, Bhanuprakash, Raghavendra DS, and Sanjeev D rao, “Presepsin: A Novel and Potential Diagnostic Biomarker for Sepsis.” American Journal of Medical and Biological Research, vol. 2, no. 4 (2014): 97-100. doi: 10.12691/ajmbr- 2-4-3. 1. Introduction Sepsis and septic shock are among the most important medical emergencies throughout the world. Advancement in the life support technologies have proven to be insufficient in reducing the mortality and morbidity arising from severe sepsis. In the era of multi-drug resistance, it becomes imperative that such cases should be diagnosed at the earliest and appropriate treatment and management measures should be initiated for better patient outcome/care [1]. Sepsis is defined as the two fold increase in inflammatory indicators. Some of the biomarkers currently available include C-reactive protein (CRP), procalcitonin (PCT), Interleukin-6 (IL-6), Plasma transforming growth factor-b1, Pro-vasopressin, pro- adrenomedullin (proADM), pro-atrial natriuretic peptide and myeloid cells expressing triggering receptor-1 (TREM-1), soluble urokinase-like plasminogen receptor (suPAR) [2-8]. Among the available biomarkers of sepsis, the CRP is still routinely used as a sepsis indicator in neonates [9]. Millions of deaths are reported due to sepsis throughout the world including both developed and developing nations [10]. Sepsis has been attributed to occur in 1-2% of hospitalized patients including those who are undergoing treatment in intensive care units (ICU) [11]. Among the many biomarkers which have been evaluated for their prognostic significance only PCT was found useful until recently [12]. Although the available biomarkers of sepsis have proven to be useful, the drawbacks include their elevated activities during non septic conditions like trauma, surgery, myocardial infarction and other conditions like systemic inflammatory response syndrome (SIRS), and immune response during septic conditions. Considering the fact that sepsis due to infection is microbiologically confirmed only in 30% of the cases, it is inevitable that there is need for other indicators of sepsis [13]. 2. Presepsin: Soluble Subtype of CD14 (SCD14-ST) Some of the biomarkers currently available have proven to be having less prognostic value and cannot be useful for predicting mortality [14]. Research in this direction has paved the way for identification of CD14, a glycopeptides expressed on macrophages and monocytes, which serves as a receptor for lipopolysaccharide-lipopolysaccharide