Efficacy of pancreatic stone proteins in early diagnosis of sepsis and comparison of its temporal trends with ESR and CRP - A longitudinal observational study

WHO defines sepsis a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs.Sepsis remains a significant cause of morbidity and mortality in the paediatric population. Early detection is crucial for effective management, prompting ongoing research into reliable biomarkers. Traditionally, biomarkers such as Erythrocyte Sedimentation Rate (ESR) and C- Reactive Protein (CRP) have been utilised, but their specificity and sensitivity limitations have led to the exploration of novel indicators like Pancreatic Stone Proteins (PSP). Pancreatic stone protein (PSP), a C-type lectin protein, is a well-defined biomarker of sepsis. PSP activates polymorphonuclear neutrophils (PMNs) and aggravates multiple organ dysfunction syndrome. PSP levels are correlated with disease severity, vasopressor support, progression to organ failure, mechanical ventilation, renal replacement therapy, length of stay, and mortality. As PSP is a C-type lectin protein, it may have a role in activating innate immunity through the C-type lectin receptors (CLRs) of the study.Through this study, we aim to evaluate the diagnostic value of PSP in Indian paediatric age group, its evolving levels throughout the course of the disease and how it compares to other pre-existing markers. Existing biomarkers have proven to have a variable sensitivity in early course of sepsis, with their elevation observed in non-septic SIRS as well. There is a wide knowledge gap in early detection of sepsis, with the only diagnostic modality being a positive blood culture. As a confimatory blood culture requires a standard incubation time of 5 days, to develop a diagnostic test for confirmation of sepsis onset early on becomes pivotal in improving the existing prognostic outcomes.