Serum measurements of human neutrophil lipocalin (HNL) discriminate between acute bacterial and viral infections

Scand J Clin Lab Invest. 1995 Apr;55(2):125-31. doi: 10.3109/00365519509089604.

Abstract

Human neutrophil lipocalin (HNL) is a recently identified protein from human neutrophil granules. The concentrations of HNL in the circulation were measured, in a group of patients with acute infections, using a radioimmunoassay. The concentrations of HNL in patients infected by viruses and bacteria were 93.78 +/- 45.30 micrograms l-1 (SD), 404.14 +/- 355.02 micrograms l-1 (SD) in serum, and 47.81 +/- 18.18 micrograms l-1 (SD), 145.46 +/- 194.32 micrograms l-1 (SD) in plasma, respectively. The differences between the two patient groups were highly significant. There was a significant correlation between serum HNL and plasma HNL levels in bacterial infections (r = 0.73, p < 0.0001). The HNL serum levels also correlated with those of C-reactive protein (CRP) (r = 0.59, p < 0.0001). Determination of HNL in serum was more specific and sensitive than CRP in the distinction between viral and bacterial infections. At a cut-off of 155 micrograms l-1 (HNL in serum), the positive and negative predictive values for the diagnosis of bacterial infections were 92 and 96%, respectively, which were superior to the optimal predictive values of CRP. Thus, the determination of HNL level is useful in the diagnosis of acute bacterial infections.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / blood
  • Bacterial Infections / diagnosis*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Carrier Proteins / blood*
  • Child
  • Cytoplasmic Granules / chemistry*
  • Diagnosis, Differential
  • Female
  • Humans
  • Lipocalin-2
  • Lipocalins
  • Male
  • Middle Aged
  • Neutrophils / chemistry*
  • Neutrophils / ultrastructure
  • Oncogene Proteins*
  • Proto-Oncogene Proteins
  • Radioimmunoassay
  • Sensitivity and Specificity
  • Time Factors
  • Virus Diseases / blood
  • Virus Diseases / diagnosis*

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • Carrier Proteins
  • LCN2 protein, human
  • Lipocalin-2
  • Lipocalins
  • Oncogene Proteins
  • Proto-Oncogene Proteins
  • C-Reactive Protein