Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, KTU Tip Fakültesi, Enfeksiyon Hastaliklari, Trabzon, Turkey.
J Clin Virol. 2011 Mar;50(3):209-11. doi: 10.1016/j.jcv.2010.11.014. Epub 2010 Dec 16.
Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease caused by a tick-borne virus from the Bunyaviridae family. It has recently been reported that soluble urokinase-type plasminogen activator receptor (suPAR), secreted from endothelial cells and the mononuclear phagocyte system, one of the main targets of the CCHF virus, is a potential biomarker for several bacterial and viral infection diseases.
This study was intended to determine the diagnostic and prognostic significance of suPAR levels in CCHF.
This retrospective study was conducted between June 2006 and August 2009 using plasma from patients monitored with a diagnosis of CCHF and from healthy blood donors. Levels of plasma suPAR were determined using an enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions.
One hundred CCHF patients were enrolled in the study. The control group was made up of 53 healthy blood donors. suPAR values of 6.2 ± 4.2 were determined in the CCHF patients and of 2.3 ± 0.6 in the control group (p<0.0001). A suPAR level optimum diagnostic cut-off point of 3.06 ng/mL was determined, with an area underneath the ROC (AUROC) curve of 0.94 (95% CI: 0.89-0.97), sensitivity of 87% (95% CI: 79-93%), specificity of 92% (95% CI: 82-98%), PPV of 95% and NPV of 79%. Five of the patients died. suPAR was 18.4 ± 9.1 in the patients that died and 5.6 ± 2.6 in the survivors (p=0.034). In terms of mortality, suPAR level had an optimum diagnostic cut-off point of 10.6 ng/mL, AUROC of 0.97 (95% CI: 0.94-0.99), sensitivity of 100% (95% CI: 48-100%), specificity of 96% (95% CI: 90-99%), PPV of 50% and NPV of 100%.
Plasma suPAR level, a new biomarker, is a test that can be used in the differential diagnosis and monitoring of CCHF in patients admitted to hospital with suspected infection. The test is at the same time important in being a possible predictor of mortality.
克里米亚-刚果出血热（CCHF）是一种由布尼亚病毒科的蜱传播病毒引起的潜在致命疾病。最近有报道称，可溶性尿激酶型纤溶酶原激活物受体（suPAR）是 CCHF 病毒的主要靶标之一，从内皮细胞和单核吞噬细胞系统分泌，是几种细菌和病毒感染性疾病的潜在生物标志物。
本研究旨在确定 CCHF 中 suPAR 水平的诊断和预后意义。
本回顾性研究于 2006 年 6 月至 2009 年 8 月期间进行，使用监测诊断为 CCHF 患者和健康献血者的血浆。根据制造商的说明，使用酶联免疫吸附测定（ELISA）试剂盒测定血浆 suPAR 水平。
本研究共纳入 100 例 CCHF 患者。对照组由 53 名健康献血者组成。CCHF 患者的 suPAR 值为 6.2±4.2，对照组为 2.3±0.6（p<0.0001）。确定了 3.06ng/mL 的最佳 suPAR 诊断截断值，ROC 曲线下面积（AUROC）为 0.94（95%CI：0.89-0.97），灵敏度为 87%（95%CI：79-93%），特异性为 92%（95%CI：82-98%），PPV 为 95%，NPV 为 79%。有 5 例患者死亡。死亡患者的 suPAR 值为 18.4±9.1，幸存者为 5.6±2.6（p=0.034）。在死亡率方面，suPAR 水平的最佳诊断截断值为 10.6ng/mL，AUROC 为 0.97（95%CI：0.94-0.99），灵敏度为 100%（95%CI：48-100%），特异性为 96%（95%CI：90-99%），PPV 为 50%，NPV 为 100%。
血浆 suPAR 水平作为一种新的生物标志物，可用于鉴别诊断和监测疑似感染住院患者的 CCHF。同时，该检测对预测死亡率也很重要。
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