Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection

Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and in...

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Main Authors: Dana-Maria Bilous, Mihai Ciocîrlan, Cătălina Vlăduț, Carmen-Georgeta Fierbințeanu-Braticevici
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1871
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author Dana-Maria Bilous
Mihai Ciocîrlan
Cătălina Vlăduț
Carmen-Georgeta Fierbințeanu-Braticevici
author_facet Dana-Maria Bilous
Mihai Ciocîrlan
Cătălina Vlăduț
Carmen-Georgeta Fierbințeanu-Braticevici
author_sort Dana-Maria Bilous
collection DOAJ
description Sepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have reduced diagnostic reliability in this subgroup, due to impaired liver and renal function. Presepsin, a soluble fragment of CD14 released during phagocytic activation, has emerged as a promising biomarker for early sepsis detection. This systematic review explores the diagnostic and prognostic utility of presepsin in cirrhotic and non-cirrhotic patients with suspected infection. Data from multiple clinical studies indicate that presepsin levels correlate with infection severity and clinical scores such as SOFA and APACHE II. In cirrhotic patients, presepsin demonstrates superior sensitivity and specificity compared to conventional biomarkers, maintaining diagnostic value despite hepatic dysfunction. Its utility extends to differentiating bacterial infections from fungal infections and monitoring treatment response. While preliminary evidence is compelling, further prospective, multicenter studies are required to validate its integration into standard care algorithms. Presepsin may become a valuable addition to clinical decision-making tools, particularly in hepatology-focused sepsis management.
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spelling doaj-art-d6bbbe88f6004c17a3cdf529140555aa2025-08-20T03:02:58ZengMDPI AGDiagnostics2075-44182025-07-011515187110.3390/diagnostics15151871Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis DetectionDana-Maria Bilous0Mihai Ciocîrlan1Cătălina Vlăduț2Carmen-Georgeta Fierbințeanu-Braticevici3Gastroenterology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaGastroenterology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaGastroenterology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaGastroenterology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaSepsis represents a major cause of mortality, especially among patients with liver cirrhosis, who are at increased risk due to immune dysfunction, gut-derived bacterial translocation, and altered hepatic metabolism. Traditional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) often have reduced diagnostic reliability in this subgroup, due to impaired liver and renal function. Presepsin, a soluble fragment of CD14 released during phagocytic activation, has emerged as a promising biomarker for early sepsis detection. This systematic review explores the diagnostic and prognostic utility of presepsin in cirrhotic and non-cirrhotic patients with suspected infection. Data from multiple clinical studies indicate that presepsin levels correlate with infection severity and clinical scores such as SOFA and APACHE II. In cirrhotic patients, presepsin demonstrates superior sensitivity and specificity compared to conventional biomarkers, maintaining diagnostic value despite hepatic dysfunction. Its utility extends to differentiating bacterial infections from fungal infections and monitoring treatment response. While preliminary evidence is compelling, further prospective, multicenter studies are required to validate its integration into standard care algorithms. Presepsin may become a valuable addition to clinical decision-making tools, particularly in hepatology-focused sepsis management.https://www.mdpi.com/2075-4418/15/15/1871presepsinsepsisliver cirrhosis
spellingShingle Dana-Maria Bilous
Mihai Ciocîrlan
Cătălina Vlăduț
Carmen-Georgeta Fierbințeanu-Braticevici
Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
Diagnostics
presepsin
sepsis
liver cirrhosis
title Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
title_full Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
title_fullStr Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
title_full_unstemmed Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
title_short Presepsin in Hepatic Pathology: Bridging the Gap in Early Sepsis Detection
title_sort presepsin in hepatic pathology bridging the gap in early sepsis detection
topic presepsin
sepsis
liver cirrhosis
url https://www.mdpi.com/2075-4418/15/15/1871
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