Publications about suPAR
suPAR Monograph
A Monograph has been written based on more than 700 peer-reviewed papers on suPAR. It summarises the research done on suPAR within a number of different clinical disease areas and discusses the impact suPAR has for each individual disease.
A summary of each disease area is available here: Clinical Use.
The suPAR Monograph can be obtained here:
suPAR Monograph (English, June 2021)
suPAR Monograph (Spanish, May 2019)
See publications on suPAR in PubMed within your specific area of interest
Examples of cornerstone papers on suPAR
“qSOFA combined with suPAR for early risk detection and guidance of antibiotic treatment in the emergency department: a randomized controlled trial”, published in the Critical Care in February 2024.
The goal of the SUPERIOR trial by Maria Evangelia Adami et al. was to answer the question: Can we use suPAR to identify septic patients in need of early treatment?
The randomized controlled trial included patients over the age of 18 with suspicion of infection, qSOFA=1, and a suPAR blood level of 12 ng/mL or more. Patients were randomized 1:1 to either broad-spectrum antibiotics (meropenem) or placebo. The primary endpoint was early deterioration, defined as at least one-point increase of admission qSOFA score the first 24 hours.
The SUPERIOR trial successfully achieved its primary objective. Measuring suPAR levels in patients admitted to the emergency department with a qSOFA=1 can identify patients in high risk of unfavorable outcomes and guide the decision to provide early treatment. Furthermore, the trial met four other vital endpoints, including preventing a ≥ 2-point increase in admission in the SOFA score occurring within the initial 24 hours, increasing infection resolution, decreasing the time to infection resolution, and providing validation for the prognostic performance of combining qSOFA and suPAR.
“Association Between Elevated suPAR, a New Biomarker of Inflammation, and Accelerated Aging”, published in the Journals of Gerontology in July 2020. The study shows that high suPAR levels were associated with an accelerated biological aging process across various organ systems, older facial appearance, and signs of older brain age. Participants with higher suPAR levels also showed a decline in physical and cognitive function from childhood to adulthood compared to those with lower suPAR. Improvements in health habits between ages 38 and 45 were associated with less steep increases of suPAR levels over those years.
These findings support the utility of suPAR in studying the role of chronic inflammation in aging and functional decline.
“Combining National Early Warning Score With Soluble Urokinase Plasminogen Activator Receptor (suPAR) Improves Risk Prediction in Acute Medical Patients: A Registry-Based Cohort Study”, published in Critical Care in December 2018.
The National Early Warning Score (NEWS) and suPAR were both connected to the risk of in-hospital-, 30-day, and 90-day mortality in acute medical patients. The suPAR level increased with increasing NEWS, and high suPAR independently predicted the risk of mortality across different NEWS scores.
This means that suPAR adds prognostic value to NEWS, particularly in patients without clinical signs of deterioration. Patients with low NEWS but high suPAR levels had a life expectancy compared to those with high NEWS scores.
The addition of suPAR to NEWS significantly improves risk prediction of low- and high-risk acute medical patients.
“Circulating soluble urokinase plasminogen activator receptor predicts cancer, cardiovascular disease, diabetes and mortality in the general population”, published in the International Journal of Infectious Diseases in April 2021.
The study by Abderrahim Oulhaj et al. included 403 RT-PCR confirmed COVID-19 patients. All were admitted due to COVID-19 regardless of baseline disease severity. Primary endpoints included the time from admission to the progression of the composite outcome, including acute respiratory distress syndrome, intensive care unit admission, or death.
The study showed that patients meeting the primary endpoints were found to have a higher baseline suPAR level than those who survived (5.5 ng/mL vs 4.1 ng/mL, p < 0.0001). The authors found that baseline suPAR levels were linked directly to the incidence of the primary endpoints. The study also included a risk analysis showing that the higher the suPAR level, the higher the risk of facing COVID-19 complications. For every increase of 1 ng/mL in the suPAR level, there was a corresponding increase of 58% in the risk of facing COVID-19 complications.
The authors concluded that suPAR has an excellent prognostic utility in predicting severe complications in hospitalized COVID-19 patients.
