Progranulin As A Novel Biomarker In Diagnosis Of Early-onset Neonatal Sepsis

Background:Sepsis is the leading cause of mortality in neonates.The newborn's immune system is immature and the condition develops rapidly.As early diagnosis and treatment of neonatal sepsis can effectively reduce mortality,the identification of new or complementary biomarkers is of great importance.In this study,we have evaluated the diagnostic value of progranulin(PGRN)in early-onset neonatal sepsis(EOS)and compare its effectiveness with other commonly used biomarkers,such as procalcitonin(PCT)and C-reactive protein(CRP).Methods:A total of 121 infants with a gestational age of > 34 weeks admitted with suspected EOS were included in this study.Before initiating therapy,blood samples for whole blood count,CRP,PCT and PGRN were obtained from all neonates.Receiver-operating characteristic(ROC)curve and multivariate logistic regression analyses were performed.Results:Serum PGRN level of infected group was significantly higher than uninfected group(median 47.72 ng/ml vs.37.86 ng/ml,respectively;Mann-Whitney p < 0.0001).The ROC area under the curve(AUC)was 0.786 [95% confidence interval(CI)0.706-0.867;p < 0.0001] for PGRN,0.699(95% CI 0.601-0.797;p = 0.0001)for age adjusted PCT,and 0.673(95% CI 0.573-0.773;p = 0.0007)for CRP.With a cut-off value of 37.89 ng/ml,the diagnostic sensitivity and negative predictive value of PGRN were 94.34% and 91.7%,respectively.PGRN could significantly predict EOS independently of PCT(p < 0.0001),and the combined use of PGRN and PCT could significantly improve diagnostic performance for EOS(0.806;95% CI 0.73-0.88;p < 0.0001),with a specificity of 89.06% and a positive predictive value of 81.10%.Conclusions:PGRN may be used as a promising biomarker for the diagnosis of EOS,and the combined use of PGRN and PCT could improve the diagnosis of sepsis.