A prospective observational cohort study to identify inflammatory biomarkers for the diagnosis and prognosis of patients with sepsis

Autor: Heylen D, Agnes Meersman, Gökhan Ertaylan, Inge Grondman, Inge C. Gyssens, Cartuyvels R, D’Onofrio, Mihai G. Netea, Dirk Valkenborg, Messiaen P, Vanwalleghem J, Pusparum M, Leo A. B. Joosten
Přispěvatelé: D'ONOFRIO, Valentino, HEYLEN, Dries, PUSPARUM, Murih, Grondman, Inge, VANWALLEGHEM, Johan, Meersman , Agnes, Cartuyvels, Reinoud, MESSIAEN, Peter, Joosten, Leo A. B., Netea, Mihai G., VALKENBORG, Dirk, Ertaylan, Gokhan, GYSSENS, Inge
Rok vydání: 2022
Předmět:
Zdroj: Journal of Intensive Care, 10
JOURNAL OF INTENSIVE CARE
Journal of Intensive Care, 10, 1
ISSN: 0384-1162
2052-0492
Popis: Background Sepsis is a life-threatening organ dysfunction. A fast diagnosis is crucial for patient management. Proteins that are synthesized during the inflammatory response can be used as biomarkers, helping in a rapid clinical assessment or an early diagnosis of infection. The aim of this study was to identify biomarkers of inflammation for the diagnosis and prognosis of infection in patients with suspected sepsis. Methods In total 406 episodes were included in a prospective cohort study. Plasma was collected from all patients with suspected sepsis, for whom blood cultures were drawn, in the emergency department (ED), the department of infectious diseases, or the haemodialysis unit on the first day of a new episode. Samples were analysed using a 92-plex proteomic panel based on a proximity extension assay with oligonucleotide-labelled antibody probe pairs (OLink, Uppsala, Sweden). Supervised and unsupervised differential expression analyses and pathway enrichment analyses were performed to search for inflammatory proteins that were different between patients with viral or bacterial sepsis and between patients with worse or less severe outcome. Results Supervised differential expression analysis revealed 21 proteins that were significantly lower in circulation of patients with viral infections compared to patients with bacterial infections. More strongly, higher expression levels were observed for 38 proteins in patients with high SOFA scores (> 4), and for 21 proteins in patients with worse outcome. These proteins are mostly involved in pathways known to be activated early in the inflammatory response. Unsupervised, hierarchical clustering confirmed that inflammatory response was more strongly related to disease severity than to aetiology. Conclusion Several differentially expressed inflammatory proteins were identified that could be used as biomarkers for sepsis. These proteins are mostly related to disease severity. Within the setting of an emergency department, they could be used for outcome prediction, patient monitoring, and directing diagnostics. Trail registration number: clinicaltrial.gov identifier NCT03841162. This study is part of the FAPIC project and has received funding from the European Union’s Horizon 2020 research and innovation program under GA 634137. The human biological material used in this publication was stored in and released from the University Biobank Limburg (UBiLim) [16]. This study is part of the Limburg Clinical Research Center (LCRC) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk (LSM), Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital. This research has been presented as an e-poster during the European Conference of Clinical Microbiology and Infectious Diseases (ECCMID), July 2021.
Databáze: OpenAIRE
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