Pathogenetic Mechanism of Procalcitonin in COVID-19

Franz J Wiedermann

Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Tyrol, Austria

Corresponding Author: Franz J Wiedermann, Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Tyrol, Austria, Phone: +43-512-504 22400, e-mail: franz.wiedermann@i-med.ac.at

How to cite this article: Wiedermann FJ. Pathogenetic Mechanism of Procalcitonin in COVID-19. Indian J Crit Care Med 2021;25(5):594.

Source of support: Nil

Conflict of interest: None

Indian Journal of Critical Care Medicine (2021): 10.5005/jp-journals-10071-23812

Dear Sir,

In the Editorial by Savio entitled “Procalcitonin (in COVID-19): The Incessant Quest,” the author wrote that the pathogenetic mechanism for the cause–effect of procalcitonin (PCT) to raise the risk of developing a severe disease remains to be proved.¹

The author wants to point to two previously published studies. In the year 2002, the results of an in vitro study revealed that in vitro PCT is a monocyte chemoattractant that deactivates chemotaxis in the presence of additional inflammatory mediators. Nylen et al. demonstrate that increased PCT exacerbates mortality in experimental sepsis, whereas neutralization of PCT increases survival. Thus, PCT, in addition to being an important marker of severity of systemic inflammation and mortality, is an integral part of the inflammatory process and directly affects the outcome.²,³

Our institution has the laboratory possibility to investigate fragments of PCT in a bioassay in order to determine the active part of the peptide PCT. In the future, there is the option to create an agonist and antagonist of PCT. This new molecule should be able to influence the pathogenetic role of PCT in severe sepsis.

ORCID

REFERENCES

1. Savio RD. Procalcitonin (in COVID-19): the incessant quest. Indican J Crit Care Med 2021;25(1):1–2. DOI: 10.5005/jp-journals-10071-23698.

2. Wiedermann FJ, Kaneider N, Egger P, Tiefenthaler W, Wiedermann CJ, Lindner KH, et al. Migration of human monocytes in response to procalcitonin. Crit Care Med 2002;30(5):1112–1117. DOI: 10.1097/00003246-200205000-00025. PMID: 12006810.

3. Nylen ES, Whang KT, Snider RH Jr, Steinwald PM, White JC, Becker KL. Mortality is increased by procalcitonin and decreased by an antiserum rective to procalcitonin in experimetnal sepsis. Crit Care Med 1998;26(6):1001–1006. DOI: 10.1097/00003246-199806000-00015. PMID: 9635646.

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