Department of Dermatology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Dis Markers. 2018 Dec 16;2018:9758473. doi: 10.1155/2018/9758473. eCollection 2018.
Patients with generalized pustular psoriasis (GPP) often present with symptoms that must be differentiated from sepsis. Procalcitonin (PCT) and presepsin (P-SEP) are widely used as biomarkers for sepsis; therefore, we examined the serum PCT and P-SEP levels in patients with psoriatic diseases. The enrolled patients included 27 with psoriasis vulgaris (PV) (22 males, 5 females; mean age 47.7 years), 12 with psoriatic arthritis (PsA) (8 males, 4 females; mean age 51.3 years), and 15 with GPP (10 males, 5 females; mean age 63.7 years). The mean serum PCT levels in patients with PV, PsA, and GPP were 0.01 ng/mL (25th-75th percentile; 0.00-0.03), 0.013 ng/mL (0.00-0.03), and 0.12 ng/mL (0.05-0.18), respectively; the levels of PCT were higher for patients with GPP than with PV or PsA but were lower than the PCT cutoff value (0.5 ng/mL) for the diagnosis of infection. The mean serum P-SEP levels in patients with PV, PsA, and GPP were 144.9 pg/mL (25th-75th percentile; 78-181), 168.1 pg/mL (124-203), and 479.9 pg/mL (216-581), respectively. Unexpectedly, the levels of P-SEP in the patients with GPP were as high as the P-SEP cutoff value (317 to 647 pg/mL) used for the diagnosis of infection. We also found that neutrophils produced P-SEP, suggesting that the high serum P-SEP levels in patients with GPP might arise at least in part due to the P-SEP derived from neutrophils activated in GPP. Both serum PCT and P-SEP might therefore be useful as novel serum biomarkers for GPP because their levels were decreased by GPP treatments. However, the measurement of PCT might be more useful than the measurement of P-SEP for discriminating between GPP and sepsis.
患有泛发性脓疱型银屑病（GPP）的患者常有症状，必须与脓毒症相鉴别。降钙素原（PCT）和前降钙素（P-SEP）被广泛用作脓毒症的生物标志物；因此，我们检测了患有银屑病疾病患者的血清 PCT 和 P-SEP 水平。纳入的患者包括 27 例寻常型银屑病（PV）（22 例男性，5 例女性；平均年龄 47.7 岁）、12 例银屑病关节炎（PsA）（8 例男性，4 例女性；平均年龄 51.3 岁）和 15 例 GPP（10 例男性，5 例女性；平均年龄 63.7 岁）。PV、PsA 和 GPP 患者的血清 PCT 平均水平分别为 0.01ng/ml（25-75 分位；0.00-0.03）、0.013ng/ml（0.00-0.03）和 0.12ng/ml（0.05-0.18）；GPP 患者的 PCT 水平高于 PV 或 PsA，但低于感染诊断的 PCT 截断值（0.5ng/ml）。PV、PsA 和 GPP 患者的血清 P-SEP 平均水平分别为 144.9pg/ml（25-75 分位；78-181）、168.1pg/ml（124-203）和 479.9pg/ml（216-581）。出乎意料的是，GPP 患者的 P-SEP 水平高达感染诊断中使用的 P-SEP 截断值（317 至 647pg/ml）。我们还发现中性粒细胞产生 P-SEP，表明 GPP 患者血清中高 P-SEP 水平至少部分源于 GPP 中激活的中性粒细胞衍生的 P-SEP。由于 GPP 治疗降低了血清 PCT 和 P-SEP 水平，因此两者均可用作 GPP 的新型血清生物标志物。然而，与 P-SEP 相比，PCT 的测量可能更有助于区分 GPP 和脓毒症。
