NT-proCNP in sepsis-induced brain dysfunction

Sepsis-induced brain dysfunction, referred to as sepsis-associated encephalopathy (SAE), is a common complication of sepsis affecting over half of sepsis patients in critical care units. It is linked to increased rates of mortality, morbidity, and long-term cognitive disability (1). The evaluation of SAE is crucial as it may be present in early stages of sepsis even before the diagnostic criteria for sepsis may be met (2). Biomarkers that are associated with brain injury could provide insights into the pathophysiological mechanisms of SAE and may be useful in patients for whom clinical assessment is challenging. C-type natriuretic peptide (CNP) and its amino-terminal propeptide NT-proCNP are natriuretic peptides, expressed in the vascular endothelium of many organs including the brain (3). Inflammatory mediators like IL-1 β and TNF-α can induce the release of NT-proCNP, suggesting a connection between systemic inflammation and the secretion and the regulation of NT-proCNP (4).

NT-proCNP in sepsis-induced brain dysfunction

The specific role of NT-proCNP as a biomarker for the assessment of SAE has been studied by Ehler et al., investigating NT-proCNP plasma concentrations in patients diagnosed with septic encephalopathy. The study revealed that highly elevated NT-proCNP levels in the early phase of sepsis might serve as an indicator for predicting the onset of SAE as the disease progresses (5).

NT-proCNP can reliably be measured in biological fluids with an ELISA assay from BIOMEDICA.

NT-proCNP ELISA (cat. no. BI-20823) kit highlights 

o   EFFICIENT – 20µl/well sample volume

o   CONVENIENT – 7 ready to use calibrators and 2 controls included

o   QUALITY – full validation following international quality guidelines

o   TRUSTED – widely cited

– Protocols available for urine, cell culture and non-human samples

Example of a Biomedica ELISA kit

 

MEASUREMENT OF NT-proCNP in NON-HUMAN SAMPLES

The sequence homology of NT-proCNP is very conserved among different species. We therefore assessed if the assay which is validated for human samples can be used in rat, mouse and pig samples. Other species types that share a high homology to human NT-proCNP can likely be measured with this assay (e.g. monkey, cats, dogs).  Learn more (NT-proCNP ELISA validation file pages 15-17). 

Literature

1. Septic-Associated Encephalopathy: a Comprehensive Review. Mazeraud A, Righy C, Bouchereau E, Benghanem S, Bozza FA, Sharshar T. Neurotherapeutics. 2020 Apr;17(2):392-403. doi: 10.1007/s13311-020-00862-1. PMID: 32378026; PMCID: PMC7283452.
2. Sepsis Associated Encephalopathy. Chaudhry N, Duggal AK.Adv Med. 2014;2014:762320. doi: 10.1155/2014/762320. Epub 2014 Sep 30. PMID: 26556425; PMCID: PMC4590973.
3. Prognostic value of circulating amino-terminal pro-C-type natriuretic peptide in critically ill patients. Koch A, Voigt S, Sanson E, Dückers H, Horn A, Zimmermann HW, Trautwein C, Tacke F.Crit Care. 2011;15(1):R45. doi: 10.1186/cc10007. Epub 2011 Jan 31. PMID: 21281508; PMCID: PMC3221974.
4. Inflammatory cytokines and NT-proCNP in Parkinson’s disease patients. Koziorowski D, Tomasiuk R, Szlufik S, Friedman A.Cytokine. 2012 Dec;60(3):762-6. doi: 10.1016/j.cyto.2012.07.030. Epub 2012 Aug 19. PMID: 22910321.
5. Diagnostic value of NT-proCNP compared to NSE and S100B in cerebrospinal fluid and plasma of patients with sepsis-associated encephalopathy. Ehler J, Saller T, Wittstock M, Rommer PS, Chappell D, Zwissler B, Grossmann A, Richter G, Reuter DA, Nöldge-Schomburg G, Sauer M. Neurosci Lett. 2019 Jan 23;692:167-173. doi: 10.1016/j.neulet.2018.11.014. Epub 2018 Nov 10. PMID: 30423400.