Sphingotest bio-ADM Biomarker for Guidance of Vasopressor Administration in Acute Diseases
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sphingotest® bio-ADM Biomarker for Guidance of Vasopressor Administration in Acute Diseases
sphingotec’s Acute
Disease Biomarkers
sphingotec offers biomarkers for use in acute diseases. These biomarkers
are used to help guide urgent clinical decisions in the emergency depart
ment and in intensive care units in hospitals.
Acute diseases such as sepsis or acute myocardial infarction are often
accompanied by shock that is initiated by systemic vasodilation and organ
failure. In most cases this results in kidney failure. It is therefore an unmet
medical need to identify and predict systemic vasodilation that may lead
to shock and also to speedily identify and predict kidney failure in patients
with sepsis or acute myocardial infarction.
sphingotec’s acute disease
biomarkers bio-ADM and
penKid do just that by
enabling early intervention
Acute MI or Stroke in these acute diseases.
The clinical use of these
biomarkers has been
validated by sphingotec in
the following settings:
Most patients sepsis, Acute Kidney Injury
... are killed short term/midterm
survive > 1 day,
by comorbidities like
but ... (AKI) and acute myocardial
infarction (AMI).
Micro-
Kidney
Infection circulatory
Dysfunction
Dysfunction
Biomarkers
Procalcitonin bio-ADM penKid
for diagnosis
About the
bio-ADM Assay
The sphingotec bio-ADM assay (sphingotest® however waiting too long may lead to a drop in
bio-ADM) is the only IVD method measuring the blood pressure resulting in organs becoming
level of bioactive adrenomedullin by using a insufficiently perfused at this stage. It is an unmet
sandwich of a C-terminal antibody specific for medical need and of immense urgency to quickly
amide-terminus and an antibody avoiding the identify patients with acute diseases in need of
N-terminal epitope leading to increased analyte vasopressors so that vasopressors/catecholamines
stability. can be administrated in emergency departments
and intensive care units at the right point of time.
The need for guidance of vasopressor
administration in acute diseases
According to standard care procedures in hos-
pitals, vasopressors are administered to a patient
sphingotest®
after the mean arterial pressure has dropped to
65mm Hg or below. Administrating vasopressors
to patients not needing them might be harmful,
bio-ADM
Prediction and
diagnosis of circulation
dysfunction
bio-ADM (bioactive adrenomedullin) is a soluble peptide hormone with
a molecular weight of approximately 6kDa. Mainly released by endothelial
cells, its biological function is to control vasodilation, an important
regulator of blood pressure and organ perfusion1, 2.
This marker predicts and provides a diagnosis for circulation dysfunction.
The level of bio-ADM in blood samples of patients in acute condition may
be used as an early indicator for the need to administrator vasopressors/
catecholamines before the blood pressure of the patient drops to levels
that endanger the life of the patient.
Healthy SEPSIS SEVERE SEPSIS SEPTIC SHOCK
Normal Systemic Organ
Death
blood flow Vasodilation Failure
Adrenomedullin
1 Kitamura K et al. , Biochem Biophys Res Commun., 192:553–60, 1993
2 Ishimitsu T et al., Pharmacol Ther. 2006 Sep;111(3):909-27
Evidence for the use
of bio-ADM in acute
myocardial infarction
(AMI)3
STEMI (ST-Elevated Myocardial Infarction) and NSTEMI bio-ADM Multivariate P value
(Non-ST-Elevated Myocardial Infarction) patients
MACE 1 year 1.32 (1.09-1.59) 0.004
admitted to the University Hospitals of Leicester NHS
MACE 30 days 1.37 (1.04-1.79) 0.023
Trust between August 2004 and April 2007 were
MACE 90 days 1.39 (1.10-1.75) 0.005
included in a study conducted to investigate the
prognostic value of bio-ADM for MACE after MI 1 years 1.34 (1.03-1.75) 0.029
6 months or 2 years. MACE is defined as composite Dead 1 year 1.52 (1.12-2.05) 0.007
endpoint of all-cause mortality, heart failure (HF) Dead/MI 1 year 1.48 (1.20-1.82)Prediction and
diagnosis of circulation
dysfunction
The association of bio-ADM with sepsis severity and outcome (28 day
mortality) in baseline and serial measurements has been investigated in
a Rome-based study where 101 consecutive patients (61 males
and 40 females) with median (IQR) age 78 (72 to 83 years) admitted to
the emergency department with suspected sepsis (at least two systemic
inflammatory response syndrome criteria plus clinical suspicion of
infection) were enrolled. Plasma samples for bio-ADM measurement were
taken and over the following four days and 28-day mortality rate was
recorded.
bio-ADM was negatively correlated
with mean arterial pressure
(r = −0.39; PEvidence for
the use of
bio-ADM in sepsis4
In addition the potential value of serial bio-ADM above 70 pg/mL every day until 4 days after
measurement has been shown for prediction admission. A 100% survival rate has been observed
of 28-day mortality. At admission patients with a for those patients with decreased bio-ADM
bio-ADM concentration above 70 pg/mL had a concentrations below 70 pg/mL within 4 days after
28-day survival rate of 55% which decreased to admission.
36% if the bio-ADM concentration had remained
100 100
Proportion of patients surviving (%)
Proportion of patients surviving (%)
0 0
0 7 14 21 28 0 7 14 21 28
ADM, 0 < 70, n = 61, events = 11 ADM, 0 > 70, ADM, 4 < 70, n = 12, events = 0
ADM, 0 < 70, n = 40, events = 18 ADM, 0 > 70, ADM, 4 > 70, n = 28, events = 18
p = 0.00341 p = 0.00052
Illustration of added value of serial bio-ADM measurement. Kaplan-Meier Plots for survival are shown for patients with bio-ADM values above or below 70 pg/mL
on admission (left) and for the subgroup of patients, who were above 70 pg/mL on admission and spread into those with bio-ADM values above or below 70 pg/mL
4 days later (right).
4 Marino R et al. Critical Care 2014, 18:R34sphingotec GmbH aims to develop diagnostic methods for prediction, prevention,
intervention strategies and early treatment of diseases in the fields of cancer,
cardiovascular diseases and kidney function. In order to realize this mission we
provide biomarkers indicating susceptibility for a specific disease which enables the
monitoring of prevention and intervention strategies. The company was established
in 2002 by Dr. Andreas Bergmann who is one of the founders and managers of
BRAHMS Aktiengesellschaft where, in addition to several other biomarkers, the
sepsis marker Procalcitonin (B.R.A.H.M.S PCT®: www.procalcitonin.com) was
developed in his role as Chief Research Officer. This biomarker Procalcitonin created
a new diagnostic standard of care supporting patient management in sepsis.
sphingotec is located in Hennigsdorf, northwest of Berlin, Germany, with its facilities
in the Technology Campus one of the largest industrial parks in Berlin and
Brandenburg with several companies of the biotechnology branch located there.
Images: Thinkstockphoto, sphingotec | WE-EN-ADM_R001
Further information can be obtained here:
sphingotec GmbH
Neuendorfstrasse 15A, 16761 Hennigsdorf
Germany
Phone +49 33 02/2 05 65-0
info@sphingotec.com, www.sphingotec.comYou can also read
