Biomarkers of sepsis and their potential value in diagnosis, prognosis and treatment

Abstract

Biomarkers have great potential to improve the diagnosis and treatment of sepsis. The available literature supports the potential utility of sTREM-1, IL-27, suPAR, neutrophil CD64, presepsin, cfDNA and miRNAs as novel diagnostic, prognostic and treatment response biomarkers. The future of sepsis biomarkers lies in extensive validation studies of such novel biomarkers across heterogeneous populations and exploration of their power in combination. Furthermore, the use of a companion diagnostics model may augment the ability of investigators to identify novel sepsis biomarkers and develop specific therapeutic strategies based on biomarker information.

Investigation of biomarker variations post-return of spontaneous circulation following an out-of-hospital cardiac arrest

“…No studies reporting levels of presepsin in patients with ROSC following cardiac arrest were found in the literature. In our study, pre-hospital presepsin values in the whole group were 500 pg/mL, similar to levels seen in a group of patients with cardiogenic shock with or without infectious complications [18] and a rapid increase of presepsin was observed at 2 hours for both survivors and non-survivors. We did not collect patient diagnosis and therefore we cannot exclude the presence of sepsis and its association with higher presepsin levels in the whole sample and higher CRP levels in survivors.…”

“…Post-cardiac arrest immune-inflammatory response, especially the level of CRP, has been correlated with patients' survival following cardiac arrest [16]. The levels of N-terminal fragment of the soluble CD14 form, known as presepsin, produced by hepatocytes and involved in the immune responses of endothelial and epithelial cells [17] increases in the serum during the inflammatory stress, and has been proposed as a serum biomarker for early diagnosis of sepsis [17,18] but its value as an inflammatory biomarker following ROSC has yet to be established.…”

AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

“…The reference standard used in these studies was defined in the ACCP/SCCM, 2001 SCCM/ESICM/ACCP/ATS/SIS and 2012 SSC guidelines. The index test (i.e., potential diagnostic biomarkers) included, among others, presepsin (sCD14-ST) (24), PCT, Neutrophil CD64 (25), sTREM-1 (26), lipopolysaccharidebinding protein, pro-adrenomedullin, pro-vasopressin and a variety of inflammatory cytokines (27)(28)(29). Furthermore, the efficacy of many scoring systems and screening tools for detecting early sepsis has been evaluated (30,31).…”

SOLUBLE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS -1 (sTREM-1) AS aDIAGNOSTIC AND PROGNOSTIC MARKER FOR LATE-ONSET SEPSIS IN PRETERM NEONATES.

“…It is a 30-kDa transmembrane glycoprotein expressed on polymorph nuclear (PMN) granulocytes and monocytes which amplifies the inflammatory response initiated by toll like receptors (TLRs) by triggering the release of pro inflammatory cytokines, activation of neutrophil degranulation and oxidative burst (Gomez-Pina et al, 2012; Sandquist and Wong, 2014). Soluble form of TREM-1 (sTREM-1) is a 27kDa protein produced through proteolytic cleavage of membrane-anchored TREM-1 by matrix metallo-proteinases (MMPs) (Gómez-Piña et al, 2007).…”