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Review Article

Human neutrophil lipocalin (HNL) as a biomarker of acute infections

Pages 1-8 | Received 03 Dec 2017, Accepted 14 Dec 2017, Published online: 23 Feb 2018
 

Abstract

The early and accurate discrimination between bacterial and viral causes of acute infections is the key to a better use of antibiotics and will help slow down the fast-growing resistance to commonly used antibiotics. This discrimination is in the vast majority of cases possible to achieve by blood assay of the biomarker human neutrophil lipocalin (HNL), which we showed to be uniquely increased in patients suffering from bacterial infections. In serum, sensitivities and specificities of >90% are achieved in both adults and children. In order to eliminate the need to produce serum, a whole-blood assay with an assay time of <10 min was developed in which blood neutrophils are activated to release HNL. The diagnostic accuracy of this assay also showed sensitivities and specificities of >90% in most infectious diseases and was clearly superior to contemporary assays such as blood neutrophil counts, C-reactive protein, procalcitonin, and expression of CD64 on blood neutrophils. This format lends itself to the development of a point-of-care HNL assay and will be a major step forward to accomplish the goal of accurately diagnosing patients with symptoms of acute infections within 10 min at the emergency room or at the doctor’s office.

Acknowledgements

The author is immensely grateful to all collaborators in Sweden and China who spent so much time and effort to carry through all the studies cited above. He is also very grateful to all technical staff and nurses who were involved in these studies and without whom this would never have happened.

Disclosure statement

Per Venge is the major owner of the company Diagnostics Development that owns rights to market HNL.

Additional information

Notes on contributors

Per Venge

Per Venge, MD PhD, is specialist in clinical chemistry and professor emeritus in Clinical Chemistry at the Department of Medical Sciences, Uppsala University, Uppsala, Sweden.