Host Response Biomarkers for Sepsis in the Emergency Room

Turgman, Oren; Schinkel, Michiel; Wiersinga, W. Joost

doi:10.1186/s13054-023-04367-z

Cited by 13 publications

(2 citation statements)

References 48 publications

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“…A recent review article demonstrated several emerging sepsis biomarkers that have been used in the emergency room, including presepsin, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and proadrenomedullin [33]. These emerging biomarkers elicit more sensitivity and specificity than CRP and procalcitonin do.…”

Section: Discussionmentioning

confidence: 99%

Proteomic Profiling of Early Secreted Proteins in Response to Lipopolysaccharide-Induced Vascular Endothelial Cell EA.hy926 Injury

Songjang,

Paiyabhroma,

Jumroon

et al. 2023

Biomedicines

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Sepsis is a crucial public health problem with a high mortality rate caused by a dysregulated host immune response to infection. Vascular endothelial cell injury is an important hallmark of sepsis, which leads to multiple organ failure and death. Early biomarkers to diagnose sepsis may provide early intervention and reduce risk of death. Damage-associated molecular patterns (DAMPs) are host nuclear or cytoplasmic molecules released from cells following tissue damage. We postulated that DAMPs could potentially be a novel sepsis biomarker. We used an in vitro model to determine suitable protein–DAMPs biomarkers for early sepsis diagnosis. Low and high lipopolysaccharide (LPS) doses were used to stimulate the human umbilical vein endothelial cell line EA.hy926 for 24, 48, and 72 h. Results showed that cell viability was reduced in both dose-dependent and time-dependent manners. Cell injury was corroborated by a significant increase in lactate dehydrogenase (LDH) activity within 24 h in cell-conditioned medium. Secreted protein–DAMPs in the supernatant, collected at different time points within 24 h, were characterized using shotgun proteomics LC-MS/MS analysis. Results showed that there were 2233 proteins. Among these, 181 proteins from the LPS-stimulated EA.hy926 at 1, 12, and 24 h were significantly different from those of the control. Twelve proteins were up-regulated at all three time points. Furthermore, a potential interaction analysis of predominant DAMPs-related proteins using STITCH 5.0 revealed the following associations with pathways: response to stress; bacterium; and LPS (GO:0080134; 0009617; 0032496). Markedly, alpha-2-HS-glycoprotein (AHSG or fetuin-A) and lactotransferrin (LTF) potentially presented since the first hour of LPS stimulation, and were highly up-regulated at 24 h. Taken together, we reported proteomic profiling of vascular endothelial cell-specific DAMPs in response to early an in vitro LPS stimulation, suggesting that these early damage-response protein candidates could be novel early biomarkers associated with sepsis.

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Section: Discussionmentioning

confidence: 99%

Proteomic Profiling of Early Secreted Proteins in Response to Lipopolysaccharide-Induced Vascular Endothelial Cell EA.hy926 Injury

Songjang,

Paiyabhroma,

Jumroon

et al. 2023

Biomedicines

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“…Presepsin, a novel biomarker in antimicrobial stewardship, is a soluble form of CD14 with a broad-spectrum affinity for the innate immune system that has been shown to support pathogen recognition [ 62 , 63 ]. Presepsin levels begin to increase 2 hours after infection and peak 3 hours later, suggesting a role for presepsin as an early biomarker for sepsis diagnosis [ 64 ].…”

Section: Biomarkers Informing Antibiotic Use and Discontinuationmentioning

confidence: 99%

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

Seok,

Park

2024

Korean J Intern Med

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Biomarkers are playing an increasingly important role in antimicrobial stewardship. Their applications have included use in algorithms that evaluate suspected bacterial infections or provide guidance on when to start or stop antibiotic therapy, or when therapy should be repeated over a short period (6–12 h). Diseases in which biomarkers are used as complementary tools to determine the initiation of antibiotics include sepsis, lower respiratory tract infection (LRTI), COVID-19, acute heart failure, infectious endocarditis, acute coronary syndrome, and acute pancreatitis. In addition, cut-off values of biomarkers have been used to inform the decision to discontinue antibiotics for diseases such as sepsis, LRTI, and febrile neutropenia. The biomarkers used in antimicrobial stewardship include procalcitonin (PCT), C-reactive protein (CRP), presepsin, and interleukin (IL)-1β/IL-8. The cut-off values vary depending on the disease and study, with a range of 0.25–1.0 ng/mL for PCT and 8–50 mg/L for CRP. Biomarkers can complement clinical diagnosis, but further studies of microbiological biomarkers are needed to ensure appropriate antibiotic selection.

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The Aetiology and Global Impact of Paediatric Sepsis

Bracken,

Lenihan,

Khanijau

et al. 2023

Curr Pediatr Rep

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Purpose of Review This review provides an overview of paediatric sepsis, focusing on sepsis definitions in children, global aetiology of sepsis, application of biomarkers in clinical practice, and challenges of global application of current evidence. Recent Findings Clinical definitions for paediatric sepsis vary, and a validated measurement is lacking. Aetiology varies by age and geography, with differences in healthcare, vaccination, and pathogens. Biomarkers show promise but have limited translation to clinical practice, especially in children. Summary Paediatric sepsis has a significant global impact, with high mortality and long-term morbidity, particularly in low- and middle-income countries (LMICs). Adapting definitions and validating biomarkers are crucial, especially in LMICs. Global efforts are needed to improve identification and management of paediatric sepsis, along with the evolving challenges of antimicrobial resistance (AMR). A global approach is essential to address complexities and enhance outcomes for affected children worldwide.

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Host Response Biomarkers for Sepsis in the Emergency Room

Cited by 13 publications

References 48 publications

Proteomic Profiling of Early Secreted Proteins in Response to Lipopolysaccharide-Induced Vascular Endothelial Cell EA.hy926 Injury

Proteomic Profiling of Early Secreted Proteins in Response to Lipopolysaccharide-Induced Vascular Endothelial Cell EA.hy926 Injury

Role of biomarkers in antimicrobial stewardship: physicians’ perspectives

The Aetiology and Global Impact of Paediatric Sepsis

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