Platelets and Multi-Organ Failure in Sepsis

Greco, Elisabetta; Lupia, Enrico; Bosco, Ornella; Vizio, Barbara; Montrucchio, Giuseppe

doi:10.3390/ijms18102200

Cited by 139 publications

(127 citation statements)

References 88 publications

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“…The MPV level is elevated in sepsis 45 . In sepsis, low PLT count is a well-known biomarker for severity 46 .…”

Section: Univariate Analysis Results the Normality Test Results Are mentioning

confidence: 99%

Implementation of Complementary Model using Optimal Combination of Hematological Parameters for Sepsis Screening in Patients with Fever

Choi

Trinh

et al. 2020

Sci Rep

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the early detection and timely treatment are the most important factors for improving the outcome of patients with sepsis. Sepsis-related clinical score, such as SIRS, SOFA and LODS, were defined to identify patients with suspected infection and to predict severity and mortality. A few hematological parameters associated with organ dysfunction and infection were included in the score although various clinical pathology parameters (hematology, serum chemistry and plasma coagulation) in blood sample have been found to be associated with outcome in patients with sepsis. The investigation of the parameters facilitates the implementation of a complementary model for screening sepsis to existing sepsis clinical criteria and other laboratory signs. In this study, statistical analysis on the multiple clinical pathology parameters obtained from two groups, patients with sepsis and patients with fever, was performed and the complementary model was elaborated by stepwise parameter selection and machine learning. The complementary model showed statistically better performance (AUC 0.86 vs. 0.74-0.51) than models built up with specific hematology parameters involved in each existing sepsisrelated clinical score. Our study presents the complementary model based on the optimal combination of hematological parameters for sepsis screening in patients with fever.Sepsis, a dysregulated host response to infection, is a significant public health concern across the world, with more than >31 million cases annually and a mortality of 17% 1 . In the USA, the incidence rate of sepsis is 3 in 1000 individuals, which is 750,000 cases per year 2 . For each hour sepsis treatment is delayed, sepsis mortality increases by 7.6% 3 . Therefore, early intervention is important for patients with sepsis to increase the survival rates. However, the symptoms of sepsis are frequently non-specific, leading to a delay in diagnosis of sepsis. Fever, one of the symptoms, occurs in response to infection, inflammation and trauma. While it is often first manifestation of sepsis, it also is a sign of non-infectious etiology. Its non-specific response makes the early diagnosis of sepsis difficult. Given this difficulty with diagnosis, comparison study for two groups, patients with sepsis and patients with fever (abnormally high temperature), can therefore uncover set of (bio) markers which is sensitive and specific for sepsis screening in its early state.Studies on biomarkers, clinical criteria, and predictive models have been conducted for sepsis diagnosis. Many biomarkers have been evaluated for their utility in sepsis diagnosis. It was previously confirmed that procalcitonin (PCT), lactate, C-reactive protein (CRP), cytokines, D-dimer, and pro-adrenomedullin are elevated in patients

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“…The MPV level is elevated in sepsis 45 . In sepsis, low PLT count is a well-known biomarker for severity 46 .…”

Section: Univariate Analysis Results the Normality Test Results Are mentioning

confidence: 99%

Implementation of Complementary Model using Optimal Combination of Hematological Parameters for Sepsis Screening in Patients with Fever

Choi

Trinh

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Platelets also play a role in the pathogenesis of multi-organ failure. 6 Platelet interaction with immune and endothelial cells is a well-known and conserved response against infection and sepsis. 6 In particular, the elevation of neutrophils is remarkable in these diseases.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Although the diagnosis of sepsis-associated DIC is a complex clinical problem, this exaggerated response can lead to multi-organ failure, shock, and death. 5 , 6 The severity of organ dysfunction has prognostic value, and in clinical practice is usually classified according to the Sequential Organ Failure Assessment (SOFA) score. 7 Several scoring systems for DIC have been proposed and tested, with the system proposed by the International Society of Thrombosis and Hemostasis being the most widely accepted.…”

Section: Introductionmentioning

confidence: 99%

Examination of biomarker expressions in sepsis-related DIC patients

Shimizu¹,

Konishi²,

Nomura³

2018

IJGM

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BackgroundDisseminated avascular coagulation (DIC) is the main cause of death among patients with sepsis. In particular, low platelet count is predictive of poor outcome. However, the significance of platelet activation in patients with sepsis-related DIC is poorly understood. To determine the characteristics of platelet-related abnormality in patients with sepsis-related DIC, we assessed the expression levels of several biomarkers.MethodsPlasma levels of biomarkers, including cytokines, chemokines, soluble selectins, platelet-derived microparticles (PDMPs), soluble vascular adhesion molecule 1, and high mobility group box protein 1 were measured by enzyme-linked immunosorbent assay at baseline and after 4, 7, 14, and 21 days of DIC treatment.ResultsDifferences in platelet activation and in the elevation of activated platelet-related PDMPs and of soluble P-selectin were seen between patients suffering from sepsis and hematologic malignancy with DIC. In addition, the elevation of interleukin (IL)-6 and thrombopoietin (TPO) was significant in sepsis patients with DIC. Furthermore, IL-6 and TPO promoted platelet activation in vitro.ConclusionAssessment of PDMPs, sP-selectin, IL-6, and TPO may be beneficial in the primary prevention of multi-organ failure in sepsis patients with DIC.

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“…The interactions are profoundly stimulatory in sepsis and septic shock. This process might in part be driven by increased thrombopoietin levels in the blood of sepsis patients (294,295) and has previously been acknowledged to be a significant contributing factor in organ failure (296).…”

Section: Myl9mentioning

confidence: 99%

Development of a Bioinformatics Framework for Identification and Validation of Genomic Biomarkers and Key Immunopathology Processes and Controllers in Infectious and Non-infectious Severe Inflammatory Response Syndrome

et al. 2020

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Sepsis is defined as dysregulated host response caused by systemic infection, leading to organ failure. It is a life-threatening condition, often requiring admission to an intensive care unit (ICU). The causative agents and processes involved are multifactorial but are characterized by an overarching inflammatory response, sharing elements in common with severe inflammatory response syndrome (SIRS) of non-infectious origin. Sepsis presents with a range of pathophysiological and genetic features which make clinical differentiation from SIRS very challenging. This may reflect a poor understanding of the key gene inter-activities and/or pathway associations underlying these disease processes. Improved understanding is critical for early differential recognition of sepsis and SIRS and to improve patient management and clinical outcomes. Judicious selection of gene biomarkers suitable for development of diagnostic tests/testing could make differentiation of sepsis and SIRS feasible. Here we describe a methodologic framework for the identification and validation of biomarkers in SIRS, sepsis and septic shock patients, using a 2-tier gene screening, artificial neural network (ANN) data mining technique, using previously published gene expression datasets. Eight key hub markers have been identified which may delineate distinct, core disease processes and which show potential for informing underlying immunological and pathological processes and thus patient stratification and treatment. These do not show sufficient fold change differences between the different disease states to be useful as primary diagnostic biomarkers, but are instrumental in identifying candidate pathways and other associated biomarkers for further exploration.

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Platelets and Multi-Organ Failure in Sepsis

Cited by 139 publications

References 88 publications

Implementation of Complementary Model using Optimal Combination of Hematological Parameters for Sepsis Screening in Patients with Fever

Implementation of Complementary Model using Optimal Combination of Hematological Parameters for Sepsis Screening in Patients with Fever

Examination of biomarker expressions in sepsis-related DIC patients

Development of a Bioinformatics Framework for Identification and Validation of Genomic Biomarkers and Key Immunopathology Processes and Controllers in Infectious and Non-infectious Severe Inflammatory Response Syndrome

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