Applying Transcriptomics for an Enhanced Clinical Research Framework, Implications for an Improved Research Strategy based on an Omics Approach: A Scoping Review

Abstract

Background Sepsis is a syndromic response to infection that carries a significant global health burden, with 11 million deaths reported globally in 2017. Many biomarkers have been developed over the years for early identification and prognosis in patients with sepsis. However, they lack the sensitivity and specificity for routine use in clinical practice. A significant challenge in developing a sepsis biomarker has been the lack of a robust pathobiological framework: a factor with a weak immunological basis to assess therapeutic efficacy. The transcript can aid in extrapolating immunological changes to the clinical arena. Given that transcriptomic processing forms a part of a systems biology analysis, we undertook to address the question: What is known about the relationship of the transcript to clinical sepsis? Objective Consequently, this review article envisages a systems-based approach to better understand sepsis using mRNA gene expression information. This was achieved through an examination of peer-reviewed literature identifying the relationship of the transcript to clinical sepsis. Methods Information sources included peer-reviewed PubMed-indexed journals using the PubMed database. Articles specific to sepsis were selected, being published between the years 2012 to 2022 inclusive. A content analysis of findings was conducted. Results The search strategy elicited 14,048 studies. Keywords and or mesh terms were applied as single terms or Boolean string search combinations, generating 36 studies. Literature was analyzed concerning the specific use of the transcript and its application to sepsis. Five main descriptive Sepsis categories were identified: (1) Definition; (2) Classification; (3) Severity, (4) Molecular Biomarkers, and (5) Benchmarking. Conclusions Evidence of the connection of the transcript to clinical sepsis was identified. This provided a systems perspective, interfacing transcriptomic data to parameters important in the clinical arena. The use of transcriptomic data in advancing patient sepsis care, thereby aiming to improve precision, requires further investigation.