Dipeptidyl Peptidase 3 (DPP3) cause of acute myocardial depression: sphingotec launches first IVD test for DPP3 on Nexus IB10 Point-of-Care platform
- sphingotec launched the very first CE-marked IVD assay for Dipeptidyl Peptidase 3 (DPP3), a novel biomarker able to assess outcomes in patients with cardiogenic shock at admission for further clinical validation through the critical care community
- IB10 sphingotest® DPP3 is now available on sphingotec’s proprietary automated Nexus IB10 point-of-care platform and quantitatively measures levels of circulating DPP3 in whole blood and plasma samples
- Data presented by Prof. Alexandre Mebazaa at ESC Congress 2019 in Paris provide evidence for a novel disease mechanism in which circulating DPP3 has a causal role in cardiac and renal dysfunction
- Further results presented by Prof. Mebazaa demonstrate that effects of pathological concentrations of DPP3 were immediately reversed in pre-clinical disease models upon injection of Procizumab, an anti-DPP3-antibody in preclinical development by 4TEEN4 Pharmaceuticals
- sphingotec has in-licensed global rights to distribute DPP3 on Nexus IB10 from 4TEEN4 Pharmaceuticals GmbH for diagnostic purposes in multiple indications
- The novel DPP3 test complements sphingotec’s portfolio of IVD tests for acute care biomarkers, including vascular function marker bio-ADM®and kidney function marker penKid®,designed to support decision making at ICUs and EDs
Paris, France, and Hennigsdorf/Berlin, Germany, August 31, 2019
- Diagnostics company SphingoTec GmbH (“sphingotec”, Hennigsdorf near Berlin, Germany) today launched IB10 sphingotest® DPP3, the first CE-IVD-marked point-of-care biomarker test able to quantify DPP3 blood-plasma levels, a novel and unique biomarker predicting outcomes in patients with cardiogenic shock at admission to intensive care units (ICUs). The DPP3 biomarker indicates angiotensin II and enkephalin signaling pathway disruptions leading to acute, short-term organ dysfunction. sphingotec will make the test initially available to the critical care community for further assessment of the clinical utility of the DPP3biomarkerin critical care settings. The assay is designed and validated for use with sphingotec’s fully automated Nexus IB10 whole blood point-of-care platform for rapid testing in laboratories, emergency departments and intensive care units together with a menu of standard critical care tests also available on the Nexus IB10 instrument.
DPP3 is at the core of a novel disease mechanism presented by Prof. Alexandre Mebazaa (Hôpital Lariboisière, Paris) today at ESC Congress 2019 (organised by the European Society of Cardiology ESC, Paris) and was described in detail in two high-ranking peer-reviewed publications by Prof. Mebazaa and co-workers also published today1,2.Results from independent clinical studies provide evidence that outcomes of patients with cardiogenic shock are associated with DPP3 blood concentrations. The scientists hypothesize that DPP3 is released from cells into the bloodstream upon cell death and degrades central mediators of cardiovascular function, angiotensin II as well as kidney function mediator enkephalin.
In blood samples from patients with cardiogenic shock enrolled in the OptimaCC3(N=57) and the CardShock4 (174 patients) studies, sustained high or increasing DPP3 plasma levels were associated with a significantly reduced cardiac left ventricular ejection fraction, impaired kidney function, and a markedly increased risk of mortality while decreasing levels of DPP3 were associated with higher survival. The causal role of DPP3 was further substantiated by studies in pre-clinical models in which injection of DPP3 impaired heart and kidney function. All these effects were immediately reversed in vivo following administration of the pre-clinical stage anti-DPP3 antibody Procizumab in a severe acute heart failure model. Procizumab is developed by the biopharmaceutical company 4TEEN4 Pharmaceuticals GmbH (“4TEEN4”). 4TEEN4 has recently licensed DPP3 rights to sphingotec for diagnostic purposes.
“DPP3 represents a unique biomarker at the core of a novel disease mechanism with high potential utility in diagnosing organ dysfunction and predicting outcome in cardiogenic shock as well as in a range of other acute care indications”, said Prof. Mebazaa.
Dr. Andreas Bergmann, CEO and founder of sphingotec commented: “The new disease mechanism investigated by Prof Mebazaa has huge potential to provide novel diagnostic and therapeutic options in a range of acute care settings with high unmet clinical need. To better understand clinical utility of DPP3 in the management of acute care patients, we invite the critical care community to collaborate with us in the further evaluation of this promising biomarker with our fully automated DPP3 point-of-care test in laboratory and near-patient settings.”
Takagi (2019) Circulating dipeptidyl-peptidase 3 and alteration in hemodynamics in cardiogenic shock: Results from the OptimaCC Trial, European Journal of Heart Failure
Deniau (2019) Circulating dipeptidyl peptidase-3 is a myocardial depressant factor: DPP3 inhibition rapidly and sustainably improves hemodynamics, European Journal of Heart Failure
gov NCT 01367743
gov NCT 1374867
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About Acute Heart Failure
Heart failure is a state of reduced cardiac output, in which the heart cannot pump blood through the body effectively. When symptoms appear suddenly, or a person experiences rapid worsening of existing symptoms of heart failure, this is called acute heart failure (AHF) or acute decompensated heart failure (ADHF). This condition can be life threatening and should be urgently evaluated by a physician, as outcomes can be affected by early and appropriate treatment. Heart failure is a common condition affecting more than 30 million people world-wide. Typical symptoms of acute heart failure include shortness of breath, tiredness and swelling of the feet and legs (congestion). Treatment typically involves supporting breathing and adjusting the blood pressure and, where necessary, removing excess fluid from the body by diuretic treatment. There is no cure, but long-term treatment involving medications and rehabilitation can improve the heart’s function.
About Cardiogenic Shock
Cardiogenic shock is an emergency with mortality rates up to 50 %. Most cases of cardiogenic shock occur after myocardial infarction and are defined by persistent low cardiac output state resulting in arterial hypotension, shortness of breath, reduced organ perfusion. Refractory cardiogenic shock presents as persistent organ hypoperfusion despite the administration of vasoactive treatments. Early initiation of mechanical circulatory support, early percutaneous coronary intervention, inotropes, and heart transplantation may improve outcomes for patients with cardiogenic shock.
About DPP3
Human Dipeptidyl Peptidase 3 (DPP3) is an ubiquitously expressed and highly conserved enzyme. DPP3 cleaves various bioactive peptides, such as such as angiotensin II, enkephalins. The most prominent substrate of DPP3 is angiotensin II, the central effector of the renin–angiotensin system (RAS), implicating extracellular DPP3 in the regulation of the RAS. RAS is activated in cardiovascular diseases, sepsis and septic shock and angiotensin II, in particular, has been shown to modulate many cardiovascular functions including the control of blood pressure and cardiac remodelling.
About Nexus Dx Inc. and the IB10 Platform
Nexus Dx Inc., a wholly owned subsidiary of sphingotec,headquartered in San Diego, CA, USA, is a global provider of a near patient testing system and advanced diagnostic solution. The company is improving patient care by providing the medical community with rapid and reliable testing at the point of care (POC), delivering patient information when and where it is needed most. The company has invested over $160m to develop and market the IB10 analyser system which, without the need for sample preparation, automatically separates plasma from whole blood with subsequent reliable and quantitative detection of biomarkers in the plasma by means of antibodies. With a hands-on-time of less than 3 minutes the easy-to-use system provides in only 20 minutes test results for biomarkers that are crucial in the management of critical care patients such as Procalcitonin, Troponin I, CK-MB, Myoglobin, NT-proBNP, and D-Dimer. sphingotecs proprietary test sphingotest® DPP3, an assay for Dipeptidyl Peptidase 3, a unique biomarker for signalling pathway disruptions leading to acute organ dysfunction was recently launched on Nexus IB10. Near-term product launches on Nexus IB10 will include: IB10 sphingotest® bio-ADM®, an assay for bioactive Adrenomedullin, a unique biomarker for real-time assessment of vascular integrity, and IB10 sphingotest® penKid®, an assay for Proenkephalin, a unique biomarker for real-time assessment of kidney function.
About sphingotec
SphingoTec GmbH (“sphingotec”;Hennigsdorf by Berlin, Germany) develops and markets innovativein vitro diagnostic IVD tests for novel and proprietarybiomarkers for the diagnosis, prediction and monitoring of acute medical conditions, such as acute heart failure, circulatory shock, and acute kidney injury in order to support patient management and provide guidance for treatment strategies. sphingotec’s assay portfolio includes sphingotest® bio-ADM® the assay for bioactive adrenomedullin, a unique biomarker for real-time assessment of vascular integrity in conditions like sepsis or congestive heart failure, sphingotest® penKid®, the assay for proenkephalin, a unique biomarker for real-time assessment of kidney function and sphingotest® DPP3, an assay for Dipeptidyl Peptidase 3, a unique biomarker for signalling pathway disruptions leading to acute organ dysfunction. Along with the Nexus IB10 POC platform by its subsidiary Nexus Dx Inc. (San Diego, CA, USA) acquired from Samsung in 2018, sphingotec markets a standard marker portfolio for acute care. In addition, sphingotec developed a portfolio of novel biomarkers, which predict the risks of obesity, breast cancer and cardiovascular diseases.
A new peer-reviewed study in Physiological Reports is the first to evaluate Proenkephalin A 119-159 (penKid) for kidney functional reserve (KFR) assessment, a stress test designed to reveal loss of kidney capacity that may not be apparent from routine blood tests. Within that method, penKid stood out: its dynamic had a far wider range after a protein stimulus than cystatin C (44.2% vs. 10.5% median fractional change) while reaching its maximal response within approx. two hours after protein stimulation. The results extend the published evidence for penKid beyond acute kidney injury into a potential complementary application: assessing kidney functional reserve. Hennigsdorf, Germany – October 6, 2026 – penKid has been evaluated for the first time as a marker of kidney functional reserve (KFR): a new study in Physiological Reports (1) found that its response spanned a much wider range than cystatin C and creatinine clearance after a protein stimulus. The study in 62 participants marks the first published evaluation of penKid for this use. Clinical context and unmet need Kidney function may appear normal on a standard blood test until a large portion of capacity has already gone. Kidney functional reserve testing addresses this gap by measuring how much a kidney's filtration rate can still rise in response to a stimulus, most commonly a protein meal. Once that reserve narrows, the kidney has less room to compensate for future stress such as major surgeries. The study authors note that reserve testing is rarely used in clinical practice, largely because the reference method used, creatinine clearance, is cumbersome, requiring blood and urine collection, can be difficult to perform outside specialized settings, and is affected by processes in the kidney unrelated to filtration itself. Study design and key findings Researchers at the University of New South Wales and Prince of Wales Hospital in Sydney conducted the study in 62 participants: 40 patients having heart surgery, and 22 healthy people, including volunteers, kidney donors, and patients who had a kidney auto-transplant. Participants drank a protein shake, followed by hourly collection of blood samples over a five hour-period. Urine samples were also collected for creatinine clearance testing. After a high protein intake, kidney filtration increases for a few hours: this "extra work" is what the methods were designed to measure. PenKid showed the largest dynamic response, with a median fractional increase of 44% from baseline compared with 30% for creatinine clearance and only about 10% for cystatin C. Unlike creatinine clearance, penKid differentiated healthy participants from cardiac surgery patients, who had a lower KFR. The study also found penKid measurements to be more homogeneous than creatinine clearance measurements, indicating greater consistency across assessments. PenKid was also fast, reaching its peak functional response in about two hours, similar in timing to a two-hour diabetes test (oral glucose tolerance test). Implications for clinical practice Beyond its wider dynamic range, the authors highlight practical advantages specific to penKid-based functional reserve testing: no urine collection is needed, minimal fasting is required, and penKid enables near real-time assessment of kidney functional reserve from blood samples alone. These features suggest penKid may offer a fast and simple alternative to assess how much reserve an individual patient has. "PenKid gave us a fast, consistent read on how much filtration capacity a kidney still has in reserve," said Prof. Zoltan H. Endre, corresponding author of the study, Department of Nephrology, Prince of Wales Hospital, and School of Clinical Medicine, University of New South Wales, Sydney. "A signal that's clear, captured that quickly, turns a kidney stress test from a research tool into something a clinic could actually use." About penKid, scientific insights PenKid is a biomarker for real-time assessment of kidney function. Unlike creatinine, penKid levels are not influenced by inflammation or factors such as age or sex, and prior studies show penKid can detect acute kidney injury (AKI) up to 48 hours before conventional criteria are met (2,3). The new Physiological Reports study provides data for another, complementary application: measuring kidney functional reserve to identify subclinical kidney disease. About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a biomarker company focusing on the out-licensing of innovative critical care solutions for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like acute heart failure. Discover more on www.sphingotec.com References (1) Rodrigues, C. E. et. al. (2026). Plasma proenkephalin-a facilitates measurement of human kidney functional reserve: From healthy kidney donors to polymorbid patients. Physiological Reports, 14, e71083. https://doi.org/10.14814/phy2.71083 . (2) Caironi P, et al. (2018) Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock.; https://doi.org/10.1373/clinchem.2018.288068 (3) Rosenqvist M, et. al. (2019) Proenkephalin a 119-159 (penKid) - a novel biomarker for acute kidney injury in sepsis: an observational study. BMC Emerg Med, doi: 10.1186/s12873-019-0283-9. Media Contact: Email: press@sphingotec.com Phone +49-3302-20565-0 SphingoTec GmbH Neuendorfstr. 15A 16761 Hennigsdorf, Germany
In a prospective, real-world study of 1,436 critically ill ICU patients, proenkephalin A 119–159 (penKid) provided clinically relevant information across AKI severity and during kidney replacement therapy (KRT). PenKid addressed a key unmet need in KRT management by identifying, with greater precision than standard biomarkers, patients at high risk of KRT liberation failure – helping to avoid stopping therapy too early. The findings support a future role for penKid in helping to standardize one of the few intensive care processes where the need for better decision support is widely acknowledged and current tools remain insufficient. Hennigsdorf, Germany – August 27, 2026 – SphingoTec GmbH announces the publication of new real-world data on proenkephalin A 119–159 (penKid) in critically ill patients. The data, published in Annals of Intensive Care, add to the growing body of evidence supporting penKid as a functional biomarker for kidney function and help inform clinical decision-making in AKI and KRT (1). In a prospective observational study at Heidelberg University Hospital, penKid was measured in 1,436 critically ill patients, including 138 patients receiving KRT for liberation analyses. The findings showed that penKid rose with AKI severity and, unlike serum creatinine and urine output, distinguished stage 3 AKI patients with and without an acute KRT requirement. In contrast to serum creatinine, penKid also differentiated acute KRT patients from those with pre-existing kidney failure and on chronic hemodialysis prior ICU admission, even while KRT treatment was ongoing (1). The study further showed that penKid levels increased progressively from the start of KRT, while serum creatinine decreased under treatment. Following successful liberation from KRT, penKid declined, whereas higher levels were seen in cases of liberation failure. In multivariable analysis, penKid was the strongest independent predictor of liberation failure and outperformed serum creatinine. A penKid cut-off of ≥250 pmol/L provided more than 90% specificity for liberation failure (1). By identifying patients at high risk of unsuccessful liberation, penKid may help clinicians make KRT discontinuation decisions more objectively, reduce the risk of stopping therapy too early, and support more standardized decision-making across critical care settings. “These data are important because they address a real-world clinical problem: how to better assess kidney function and support KRT decisions when standard markers fall short,” said Deborah Bergmann, CEO of SphingoTec. “penKid provides clinicians with an objective, real-time measurable parameter that may help support more informed and consistent kidney-related decisions in critical care.” Christian Nusshag, MD, Department of Nephrology, Heidelberg University Hospital, said: “Current markers often leave clinicians with an incomplete picture. Our findings suggest that penKid may help standardize decision-making by providing additional, actionable information on kidney integrity and recovery.” About penKid, scientific insights PenKid is a biomarker that enables real-time assessment of kidney function. Unlike conventional markers such as serum creatinine, penKid levels are not influenced by inflammation or other confounding factors like age or sex. Studies have shown that penKid allows earlier detection of AKI, predicting changes in serum creatinine up to 48 hours before conventional diagnostic criteria are met. This early detection capability is particularly valuable in critically ill patients, including those with sepsis or septic shock. Additionally, penKid has shown potential for monitoring renal recovery under KRT and could help predict successful liberation from KRT. About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a biomarker company focusing on the out-licensing of innovative critical care solutions for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like acute heart failure. Discover more on www.sphingotec.com References (1) Gabriel DC, Sauer P, Happel R, et al. Proenkephalin A for Assessing Kidney Integrity and Guiding KRT Liberation Decisions in Critically Ill Patients. Annals of Intensive Care. 2026. DOI: 10.1016/j.aicoj.2026.100113. Media Contact: Email: press@sphingotec.com Phone +49-3302-20565-0 SphingoTec GmbH Neuendorfstr. 15A 16761 Hennigsdorf, Germany