Survey of Clinical properties of Biomarkers in Urgent Care : The Potential for Multiplex Testing Using Olink PEA

In the intensive care unit, rapid and accurate diagnosis is critical, especially for conditions like cardiovascular disease, infectious disease and thrombosis. At hospitals today, singleplex immunochemical testing is common due to its high accuracy, where ELISA and RIA are some of the conventional methods. However, these singleplex tests are time-consuming and limited by analyzing individual biomarkers, despite the need for multiple markers to improve diagnostic precision. This review aimed to identify the different clinical properties different biomarkers contribute with for diagnosis in these three acute disease groups. A total of 22 different protein biomarkers were assessed and compared. No single biomarker was sufficient for accurate diagnosis. We want to examine if multiplex testing, by integrating multiple biomarkers within a single test, could provide a faster, more accurate, and more efficient diagnostic approach. Olink’s multiplex technique proximity extension assay (PEA) was evaluated for this purpose. We suggest that combining CK-MB, troponin, myoglobin and serum albumin in a multiplex panel could be an efficient test for acute heart disease. For detecting and monitoring of infectious diseases and sepsis, the biomarkers IL-6, TNF-α, SAA, CRP, and PCT could offer a complete and clinically useful profile. For thrombosis, the biomarkers P-selectin, D-dimer, IL-6, IL-10, and CRP are valuable and suitable for integrating into a multiplex assay. Some of the main biomarkers are overlapping for the different disease groups, emphasizing the need for additional biomarkers to enhance specificity. For a multiplex panel testing for all three disease groups simultaneously the overlapping biomarkers CRP, LDH, myoglobin, fibrinogen, P-selectin, E-selectin and interleukins combined with the specific biomarkers troponin, SAA, and D-dimer could be used. Our conclusion is that multiplex testing has great potential to improve clinical diagnostics. However, in instances with evident acute symptoms, physical examinations may still be faster and sufficient. Therefore, multiplex assays like PEA should be seen as a complementary tool to support diagnosis and guide appropriate treatment.