Diagnosis and evaluation of severity of sepsis via the use of biomarkers and profiles of 13 cytokines: a multiplex analysis

Jekarl, Dong Wook; Kim, Ji Yeon; Lee, Seungok; Kim, Myungshin; Kim, Yonggoo; Han, Kyungja; Woo, Seon Hee; Lee, Woon Jeong

doi:10.1515/cclm-2014-0607

Cited by 62 publications

(64 citation statements)

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“…This pro-inflammatory cytokine can induce the production of IFN-γ [207, 212, 214, 215, 222–228]. An elevation of circulating IL-12p70 has been reported in patients with sepsis [229–231], and preterm delivery < 35 weeks with severe histologic chorioamnionitis [228]. Our findings are consistent with these results.…”

Section: Discussionsupporting

confidence: 92%

Clinical chorioamnionitis at term V: umbilical cord plasma cytokine profile in the context of a systemic maternal inflammatory response

Romero

Chaemsaithong

Docheva

et al. 2015

Journal of Perinatal Medicine

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Objective Microbial invasion of the fetus due to intra-amniotic infection can lead to a systemic inflammatory response characterized by elevated concentrations of cytokines in the umbilical cord plasma/serum. Clinical chorioamnionitis represents the maternal syndrome often associated with intra-amniotic infection, although other causes of this syndrome have been recently described. The objective of this study was to characterize the umbilical cord plasma cytokine profile in neonates born to mothers with clinical chorioamnionitis at term, according to the presence or absence of bacteria and/or intra-amniotic inflammation. Materials and Methods A cross-sectional study was conducted, including patients with clinical chorioamnionitis at term (n=38; cases) and those with spontaneous term labor without clinical chorioamnionitis (n=77; controls). Women with clinical chorioamnionitis were classified according to the results of amniotic fluid culture, broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS), and amniotic fluid interleukin (IL)-6 concentrations into three groups: 1) no intra-amniotic inflammation; 2) intra-amniotic inflammation without detectable microorganisms; or 3) microbial-associated intra-amniotic inflammation. Fetal inflammatory response syndrome (FIRS) was defined as an umbilical cord plasma IL-6 concentration >11 pg/mL. The umbilical cord plasma concentrations of 29 cytokines were determined with sensitive and specific V-PLEX immunoassays. Nonparametric statistical methods were used for analysis, adjusting for a false discovery rate of 5%. Results 1) Neonates born to mothers with clinical chorioamnionitis at term (considered in toto) had significantly higher median umbilical cord plasma concentrations of IL-6, IL-12p70, IL-16, IL-13, IL-4, IL-10, and IL-8, but significantly lower interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) concentrations than neonates born to mothers with spontaneous term labor without clinical chorioamnionitis; 2) neonates born to mothers with clinical chorioamnionitis at term but without intra-amniotic inflammation had higher concentrations of IL-6, IL-12p70, IL-13, IL-4, IL-5, and IL-8 but lower IFN-γ than neonates not exposed to clinical chorioamnionitis, suggesting that maternal fever in the absence of intra-amniotic inflammation leads to a change in the fetal cytokine network; 3) there were significant, positive correlations between maternal and umbilical cord plasma IL-6 and IL-8 concentrations (IL-6: Spearman’s correlation=0.53; p<0.001; IL-8: Spearman’s correlation=0.42; p<0.001), consistent with placental transfer of cytokines; 4) an elevated fetal plasma IL-6 (> 11pg/mL), the diagnostic criterion for FIRS, was present in 21% of cases (8/38), and all of these neonates were born to mothers with proven intra-amniotic infection; and 5) FIRS was associated with a high concentration of umbilical cord plasma IL-8, IL-10, and monocyte chemoattractant protein (MCP)-1. Conclusions Neonates born to mothe...

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Section: Discussionsupporting

confidence: 92%

Clinical chorioamnionitis at term V: umbilical cord plasma cytokine profile in the context of a systemic maternal inflammatory response

Romero

Chaemsaithong

Docheva

et al. 2015

Journal of Perinatal Medicine

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“…A similar conclusion was also drawn by a Korean study authored by Jekarl and colleagues where PCT, interleukin (IL) 6, and CRP had a high diagnostic yield for infection diagnosis [7]. Also, PCT, IL6, and IL5 had prognostic value and correlated with severity of sepsis.…”

supporting

confidence: 73%

“Personalized” sepsis care with the help of specific biomarker levels on admission and during follow up: are we there yet?

Schuetz¹

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Finally, 86 studies were included after two updated searches in February 2015 and September 2016 (Fig. 1) (Abidi et al 2008; Ahmadinejad et al 2009; Al-Nawas et al 1996; Anand et al 2015; Balc et al 2003; Barati et al 2010; Battista et al 2016; Bell et al 2003; Beqja-Lika et al 2013; Carpio et al 2015; Castelli et al 2004; Clec’h et al 2006; de Pablo et al 2013; Dorizzi et al 2006; Du et al 2003; Endo et al 2012; Farag et al 2013; Feng et al 2012; Gaini et al 2006; Garnacho-Montero et al 2014; Gerrits et al 2013; Giamarellos-Bourboulis et al 2008; Gibot et al 2004; Godnic et al 2015; Guven et al 2002; Han et al 2016; Harbarth et al 2001; Hoenigl et al 2013; Hou et al 2012, 2016; Hsu et al 2011; Ishikura et al 2014; Ivancevic et al 2008; Jekarl et al 2013, 2014; Jiang et al 2015; Kim and Zhang 2012; Kofoed et al 2007; Latour-Perez et al 2010; Lewis et al 2015; Li et al 2013a; Lin et al 2015; Matera et al 2013; Mat-Nor et al 2016; Mearelli et al 2014; Meynaar et al 2011; Miglietta et al 2015; Miller et al 1999; Muthiah et al 2007, Naeini and Montazerolghaem 2006; Oshita et al 2010; Papadimitriou-Olivgeris et al 2015; Ratzinger et al 2013; Reichsoellner et al 2014; Righi et al 2014; Rivera-Chavez and Minei 2009; Rogina et al 2014; Romualdo et al 2014; Ruiz-Alvarez et al 2009; Sakr et al 2008; Scherpereel et al 2006; Schulte et al 2011; Selberg et al 2000; Seok et al 2012; Shozushima et al 2011; Sierra et al 2004; Su et al 2012, 2013; Sungurtekin et al …”

Section: Resultsmentioning

confidence: 99%

Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis

et al. 2016

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BackgroundSepsis is one of the most common diseases that seriously threaten human health. Although a large number of markers related to sepsis have been reported in the last two decades, the diagnostic accuracy of these biomarkers remains unclear due to the lack of similar baselines among studies. Therefore, we conducted a large systematic review and meta-analysis to evaluate the diagnostic value of biomarkers from studies that included non-infectious systemic inflammatory response syndrome patients as a control group.MethodsWe searched Medline, Embase and the reference lists of identified studies beginning in April 2014. The last retrieval was updated in September 2016.ResultsUltimately, 86 articles fulfilled the inclusion criteria. Sixty biomarkers and 10,438 subjects entered the final analysis. The areas under the receiver operating characteristic curves for the 7 most common biomarkers, including procalcitonin, C-reactive protein, interleukin 6, soluble triggering receptor expressed on myeloid cells-1, presepsin, lipopolysaccharide binding protein and CD64, were 0.85, 0.77, 0.79, 0.85, 0.88, 0.71 and 0.96, respectively. The remaining 53 biomarkers exhibited obvious variances in diagnostic value and methodological quality.ConclusionsAlthough some biomarkers displayed moderate or above moderate diagnostic value for sepsis, the limitations of the methodological quality and sample size may weaken these findings. Currently, we still lack an ideal biomarker to aid in the diagnosis of sepsis. In the future, biomarkers with better diagnostic value as well as a combined diagnosis using multiple biomarkers are expected to solve the challenge of the diagnosis of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3591-5) contains supplementary material, which is available to authorized users.

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Diagnosis and evaluation of severity of sepsis via the use of biomarkers and profiles of 13 cytokines: a multiplex analysis

Cited by 62 publications

References 20 publications

Clinical chorioamnionitis at term V: umbilical cord plasma cytokine profile in the context of a systemic maternal inflammatory response

Clinical chorioamnionitis at term V: umbilical cord plasma cytokine profile in the context of a systemic maternal inflammatory response

“Personalized” sepsis care with the help of specific biomarker levels on admission and during follow up: are we there yet?

Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis

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