This may partly explain why PCT seemed to be an inaccurate marker of SBP in patients with liver disease and the cut-off values for identifying infections were highly variable in different studies.[12–16] PCT is secreted by adherent monocytes and macrophage-activated adipocytes in inflammation.[31] Liver cells are damaged in liver diseases, whereas monocytes and adipocytes are not. This evidence concerns the gene CALCA and infection.