Copeptin: a new and promising diagnostic and prognostic marker

Mira Katan, Beat Müller, Mirjam Christ-Crain, Mira Katan, Beat Müller, Mirjam Christ-Crain

Abstract

The study conducted by Seligman and coworkers included in the previous issue of Critical Care demonstrates that copeptin is a promising marker to predict outcome in patients with ventilator-associated pneumonia. In recent years, copeptin has emerged as a new prognostic marker in a variety of diseases, such as sepsis, community-acquired pneumonia, chronic obstructive pulmonary failure, heart failure and myocardial infarction. What is the pathophysiological basis for these findings? Copeptin together with vasopressin is co-secreted from the posterior pituitary and therefore mirrors the amount of vasopressin in the circulation. Vasopressin is a main secretagogue of the hypothalamo-pituitary-adrenal axis, thereby mirroring the individual stress level. Furthermore, vasopressin is an important hormone in salt and volume regulation. In this context, copeptin is also a diagnostic marker in patients with diabetes insipidus and in patients with disordered water states.

References

    1. Seligman R, Papassotiriou J, Morgenthaler NG, Meisner M, Teixeira PJ. Copeptin, a novel prognostic biomarker in ventilator-associated pneumonia. Crit Care. 2008;12:R11. doi: 10.1186/cc6780.
    1. Luyt CE, Guerin V, Combes A, Trouillet JL, Ayed SB, Bernard M, Gibert C, Chastre J. Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia. Am J Respir Crit Care Med. 2005;171:48–53. doi: 10.1164/rccm.200406-746OC.
    1. Morgenthaler NG, Struck J, Alonso C, Bergmann A. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem. 2006;52:112–119. doi: 10.1373/clinchem.2005.060038.
    1. Szinnai G, Morgenthaler NG, Berneis K, Struck J, Muller B, Keller U, Christ-Crain M. Changes in plasma copeptin, the c-terminal portion of arginine vasopressin during water deprivation and excess in healthy subjects. J Clin Endocrinol Metab. 2007;92:3973–3978. doi: 10.1210/jc.2007-0232.
    1. Katan M, Morgenthaler N, Dixit K, Rutishauser J, Brabant G, Muller B, Christ-Crain M. Anterior and posterior pituitary function testing with simultaneous insulin tolerance test and a novel copeptin assay. J Clin Endocrinol Metab. 2007;92:2640–2643. doi: 10.1210/jc.2006-2046.
    1. Morgenthaler NG, Muller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vaso-pressin precursor, is elevated in hemorrhagic and septic shock. Shock. 2007;28:219–226. doi: 10.1097/SHK.0b013e318033e5da.
    1. Muller B, Morgenthaler N, Stolz D, Schuetz P, Muller C, Bingisser R, Bergmann A, Tamm M, Christ-Crain M. Circulating levels of copeptin, a novel biomarker, in lower respiratory tract infections. Eur J Clin Invest. 2007;37:145–152. doi: 10.1111/j.1365-2362.2007.01762.x.
    1. Stolz D, Christ-Crain M, Morgenthaler NG, Leuppi J, Miedinger D, Bingisser R, Muller C, Struck J, Muller B, Tamm M. Copeptin, C-reactive protein, and procalcitonin as prognostic biomarkers in acute exacerbation of COPD. Chest. 2007;131:1058–1067. doi: 10.1378/chest.06-2336.
    1. Gegenhuber A, Struck J, Dieplinger B, Poelz W, Pacher R, Morgenthaler NG, Bergmann A, Haltmayer M, Mueller T. Comparative evaluation of B-type natriuretic peptide, mid-regional pro-A-type natriuretic peptide, mid-regional pro-adreno-medullin, and copeptin to predict 1-year mortality in patients with acute destabilized heart failure. J Card Fail. 2007;13:42–49. doi: 10.1016/j.cardfail.2006.09.004.
    1. Stoiser B, Mortl D, Hulsmann M, Berger R, Struck J, Morgenthaler NG, Bergmann A, Pacher R. Copeptin, a fragment of the vaso-pressin precursor, as a novel predictor of outcome in heart failure. Eur J Clin Invest. 2006;36:771–778. doi: 10.1111/j.1365-2362.2006.01724.x.
    1. Khan SQ, Dhillon OS, O'Brien RJ, Struck J, Quinn PA, Morgenthaler NG, Squire IB, Davies JE, Bergmann A, Ng LL. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation. 2007;115:2103–2110. doi: 10.1161/CIRCULATIONAHA.106.685503.
    1. Christ-Crain M, Stolz D, Jutla S, Couppis O, Muller C, Bingisser R, Schuetz P, Tamm M, Edwards R, Muller B, Grossman AB. Free and total cortisol levels as predictors of severity and outcome in community-acquired pneumonia. Am J Respir Crit Care Med. 2007;176:913–920. doi: 10.1164/rccm.200702-307OC.
    1. Katan M, Morgenthaler NG, Widmer I, Puder J, König C, M MBaC-C. Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett. 2008.
    1. Robertson GL. The use of vasopressin assays in physiology and pathophysiology. Semin Nephrol. 1994;14:368–383.
    1. Morales DL, Garrido MJ, Madigan JD, Helman DN, Faber J, Williams MR, Landry DW, Oz MC. A double-blind randomized trial: prophylactic vasopressin reduces hypotension after cardiopulmonary bypass. Ann Thorac Surg. 2003;75:926–930. doi: 10.1016/S0003-4975(02)04408-9.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere