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Review
. 2024 Jun 20;14(12):1311.
doi: 10.3390/diagnostics14121311.

Presepsin in Critical Illness: Current Knowledge and Future Perspectives

Paolo Formenti  1 , Miriam Gotti  1 , Francesca Palmieri  1 , Stefano Pastori  2 , Vincenzo Roccaforte  2 , Alessandro Menozzi  3 , Andrea Galimberti  1 , Michele Umbrello  4 , Giovanni Sabbatini  1 , Angelo Pezzi  1
Affiliations
Review

Presepsin in Critical Illness: Current Knowledge and Future Perspectives

Paolo Formenti et al. Diagnostics (Basel). .

Abstract

The accurate identification of infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, alongside cost and accessibility issues. Consequently, there is a pressing need for a marker that is economically feasible, rapid, and reliable. Presepsin (PSP), also known as soluble CD14 subtype (sCD14-ST), has emerged as a promising biomarker for early sepsis diagnosis. PSP, derived from soluble CD14, reflects the activation of monocytes/macrophages in response to bacterial infections. It has shown potential as a marker of cellular immune response activation against pathogens, with plasma concentrations increasing during bacterial infections and decreasing post-antibiotic treatment. Unlike traditional markers such as procalcitonin (PCT) and C-reactive protein (CRP), PSP specifically indicates monocyte/macrophage activation. Limited studies in critical illness have explored PSP's role in sepsis, and its diagnostic accuracy varies with threshold values, impacting sensitivity and specificity. Recent meta-analyses suggest PSP's diagnostic potential for sepsis, yet its standalone effectiveness in ICU infection management remains uncertain. This review provides a comprehensive overview of PSP's utility in ICU settings, including its diagnostic accuracy, prognostic value, therapeutic implications, challenges, and future directions.

Keywords: critical care patients; presepsin; sepsis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 2
Figure 2
The mechanism of presepsin production.
Figure 1
Figure 1
Flowchart of search strategy.
See this image and copyright information in PMC

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