DPP3 – cardiac depression factor

Recently, a so far unknown disease mechanism leading to short-term organ failure was identified. According to the new findings, the release of the cardiac depressant factor Dipeptidyl-peptidase 3 (DPP3) into the bloodstream plays a major role in sudden loss of heart function.1,2

DPP3 is a natural enzyme that plays a vital role in the recycling of cellular proteins. When massive, uncontrolled cell death occurs, for example, in major surgeries, cardiogenic shock, sepsis, or burns, DPP3 is released into the bloodstream, having a toxic-like effect on the human biology. This is because in the bloodstream, DPP3 inactivates angiotensin II, a hormone that is important for the heart function. This inactivation is leading to hemodynamic instability and consequently cardiac depression.

High or rising DPP3 blood levels(1) indicate worsening of the patient’s status that can lead to short-term organ failure and death. On the other hand, decreasing DPP3 levels(2) indicate a substantially reduced mortality risk.1

Dipeptidyl-peptidase 3 (DPP3)

  • is a blood-based parameter for quantifying the DPP3-release into the blood stream
  • aids in the guidance for induction or escalation of therapy
  • aids in the stratification of patients at high risk to develop short-term organ dysfunction
  • aids in the monitoring of treatment success

The pathomechanism behind DPP3-release

Healthy state

In healthy state, DPP3 is located intracellularly (1a) and active angiotensin II (1b) contributes to maintaining a normal heart function (1c).


Disease state

In a disease state, uncontrolled cell death leads to the release of DPP3 (2a). Angiotensin II is inactivated by DPP3 (2b), which leads to haemodynamic instability and cardiac depression (2c).



The assay for measuring DPP3-release

IB10 sphingotest® DPP3 is a rapid point-of-care (POC) immunoassay for the quantitative in vitro determination of DPP3 in EDTA human whole blood and plasma.

Nexus IB10


1. Depret et al. (2020), Circulating dipeptidyl peptidase-3 at admission is associated with circulatory failure, acute kidney injury and death in severely ill burn patients. Read more
2. Deniau et al. (2019), Circulating dipeptidyl peptidase 3 is a myocardial depressant factor: dipeptidyl peptidase 3 inhibition rapidly and sustainably improves haemodynamics. Read article
3. Kaufmann et al. (2019), A novel and highly efficient purification procedure for native human dipeptidyl peptidase 3 from human blood cell lysate. Read more
4. Magliocca et al. (2019), Dipeptidyl peptidase 3, a biomarker in cardiogenic shock and hopefully much more. Read more
5. Takagi et al. (2019), Circulating dipeptidyl peptidase 3 and alteration in haemodynamics in cardiogenic shock: results from the OptimaCC trial. Read more
6. Rehfeld et al. (2018), Novel Methods for the Quantification of Dipeptidyl Peptidase 3 (DPP3) Concentration and Activity in Human Blood Samples. Read more