Clinical utility of procalcitonin and its association with pathogenic microorganisms

Abstract

In this review, we summarize the relationship of PCT with pathogens, evaluate the clinical utility of PCT in the diagnosis of clinical diseases, condition monitoring and evaluation, and guiding medical decision-making, and explore current knowledge on the mechanisms by which pathogens cause changes in PCT levels. The lipopolysaccharides of the microorganisms stimulate cytokine production in host cells, which in turn stimulates production of serum PCT. Pathogens have different virulence mechanisms that lead to variable host inflammatory responses, and differences in the specific signal transduction pathways result in variable serum PCT concentrations. The mechanisms of signal transduction have not been fully elucidated. Further studies are necessary to ascertain the PCT fluctuation range of each pathogen. PCT levels are helpful in distinguishing between certain pathogens, in deciding if antibiotics are indicated, and in monitoring response to antibiotics.

Keywords:

• Procalcitonin utility
• pathogenic microorganism
• disease diagnosis
• immune mechanism
• cutoff value
• infection

Author contributions

All authors contributed to the draft and have seen and approved the final version of the report.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81672100], Natural Science Foundation of Jiangsu Province of China [BK20181492], the National Key Clinical Department of Laboratory Medicine of China in Nanjing, Key laboratory for Laboratory Medicine of Jiangsu Province [ZDXKB2016005] and by the Priority Academic Program Development of Jiangsu Higher Education Institutions.