BIOMARCADORES SÉRICOS EN SEPSIS: PROCALCITONINA VERSUS PRESEPSINA
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Rev Cient Cienc Méd
Abstract
La sepsis, una disfunción orgánica potencialmente mortal resultante de una respuesta desregulada del huésped a una infección, requiere biomarcadores confiables para un manejo óptimo. La procalcitonina es el biomarcador más establecido, con alta especificidad para infección bacteriana, utilidad para guiar la terapia antibiótica y correlación con la gravedad. No obstante, su elevación puede ocurrir en contextos no infecciosos y su accesibilidad es variable. La presepsina, un marcador de la activación de monocitos/macrófagos, emerge como una alternativa, con una elevación potencialmente más temprana. Sin embargo, su interpretación se ve afectada por la función renal y su evidencia clínica es aún limitada. Estudios comparativos indican sensibilidades y especificidades similares, aunque la procalcitonina cuenta con mayor validación clínica. La interpretación de cualquier biomarcador debe integrarse al cuadro clínico, ya que ninguno es irrefutable. Se recomiendan más estudios multicéntricos para definir el papel óptimo de cada uno.
Sepsis, a life-threatening organ dysfunction resulting from a dysregulated host response to infection, requires reliable biomarkers for optimal management. Procalcitonin is the most established biomarker, with high specificity for bacterial infection, usefulness in guiding antibiotic therapy, and correlation with severity. However, its elevation can occur in non-infectious contexts and its accessibility is variable. Presepsin, a marker of monocyte/macrophage activation, is emerging as an alternative, with potentially earlier elevation. However, its interpretation is affected by renal function and its clinical evidence is still limited. Comparative studies indicate similar sensitivities and specificities, although procalcitonin has greater clinical validation. The interpretation of any biomarker must be integrated into the clinical picture, as none is irrefutable. Further multicenter studies are recommended to define the optimal role of each.
Sepsis, a life-threatening organ dysfunction resulting from a dysregulated host response to infection, requires reliable biomarkers for optimal management. Procalcitonin is the most established biomarker, with high specificity for bacterial infection, usefulness in guiding antibiotic therapy, and correlation with severity. However, its elevation can occur in non-infectious contexts and its accessibility is variable. Presepsin, a marker of monocyte/macrophage activation, is emerging as an alternative, with potentially earlier elevation. However, its interpretation is affected by renal function and its clinical evidence is still limited. Comparative studies indicate similar sensitivities and specificities, although procalcitonin has greater clinical validation. The interpretation of any biomarker must be integrated into the clinical picture, as none is irrefutable. Further multicenter studies are recommended to define the optimal role of each.
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Vol. 28, No. 1