Presepsin in the specimen binds to the anti-presepsin antibodies to form an immunocomplex www.selleckchem.com/products/Oligomycin-A.html with the ALP-labeled antibodies and the antibody-coated magnetic particles. After removal of the unbound ALP-labeled antibodies using MAGTRATION Technology (magnetic particles are directly washed in the dispensing cap; Precision System Science Europe GmbH, W?rrstadt, Germany), a chemiluminescent substrate is added to the immunocomplex. After a 10-min incubation period, the luminescence generated by the enzyme reaction is detected by a photomultiplier to calculate the concentration of presepsin in the samples using the measurement of light emission. The assay takes 17 min using a sample volume of 100 ��l. The entire procedure was automatically performed using the PATHFAST Immunoanalyzer (Mitsubishi Chemical Europe GmbH).

Method precision was tested on three different plasma pools with a mean presepsin concentration of 327 pg/ml (range, 700 to 7,201 pg/ml), yielding within-series coefficients of variation (CVs) of 12.3%, 3.9% and 2.8%, respectively, as well as between-series CVs of 15.0%, 7.7% and 4.2%, respectively.Quantitative analysis of PCT was performed using an automated electrochemiluminescence immunoanalyzer (ELECSYS* BRAHMS* PCT; Roche Diagnostics, Mannheim, Germany). The assay time was 18 min and was automatically performed on Cobas e601 analyzer platforms (Roche Diagnostics). According to our experience, within-run and between-run precision for this test were 5.6% and 8.8%, respectively, at 0.15 ng/ml PCT concentration, 4.2% and 5.7% at 1.7 ng/ml, and 2.5% and 4.9% at 20.

3 ng/ml, respectively.Statistical analysisThe Kruskal-Wallis test with the Bonferroni correction was used to explore the results in each group (SIRS, sepsis and severe sepsis or septic shock) at the first presentation to the ED, to examine the capability of the two biomarkers to diagnose sepsis, to analyze the different primary sites of infection and to compare the different populations in the control group (acute pancreatitis, aortic dissection, pulmonary embolism, acute coronary syndrome, multiple trauma and burns). The Mann-Whitney U test was applied to Brefeldin_A evaluate efficacy regarding 60-day mortality prediction and to analyze the diagnostic significance in the different populations in the group of patients with no infection. Correlations between biomarkers and blood test results, biomarkers and SOFA and APACHE II scores were analyzed using Spearman’s rank correlation test. The Friedman test with the Bonferroni correction was used to study the laboratory trend of biomarkers from T0 to T2. A P value less than 0.05 was considered to be significant. Statistical tests were performed using MedCalc version 10.0.1.