Sepsis Diagnostics in the Era of “Omics” Technologies

Abstract

Sepsis is a multifactorial clinical syndrome with an extremely dynamic clinical course and with high diverse clinical phenotype. Early diagnosis is crucial for the final clinical outcome. Previous studies have not identified a biomarker for the diagnosis of sepsis which would have sufficient sensitivity and specificity. Identification of the infectious agents or the use of molecular biology, next gene sequencing, has not brought significant benefit for the patient in terms of early diagnosis. Therefore, we are currently searching for biomarkers, through "omics" technologies with sufficient diagnostic specificity and sensitivity, able to predict the clinical course of the disease and the patient response to therapy. Current progress in the use of systems biology technologies brings us hope that by using big data from clinical trials such biomarkers will be found.

Multi-Organ Transcriptome Dynamics in a Mouse Model of Cecal Ligation and Puncture-Induced Polymicrobial Sepsis

“… 1 , 32 Both concurrent pro-inflammatory and anti-inflammatory phase are considered as the sepsis hallmark. 9 Other pathways with a high level of significance were Hemostasis, Platelet activation, signaling and aggregation, Platelet degranulation, and Response to elevated platelet cytosolic Ca2+, which represented the Hemostasis cluster. While all four pathways revealed overrepresentation of upregulated genes at each time point for all organs, with the exception of the lung where, at 12 hours after surgery, they represented significantly downregulated transcripts.…”

“…Although blood comes into contact with the cells, tissues, and organs of the entire organism, constituting a primary aspect of the immune defense system, comparing blood gene expression profiles from septic patients with organ transcriptomes from animal models can cause possible erroneous conclusions. 9 Furthermore, sepsis is a dynamic process within a relatively narrow time window. 1 In clinical studies blood samples are usually obtained at a single time point and, as a consequence, may represent different phases of sepsis, while in animal models organ tissue transcriptional alterations can be analyzed repeatedly at precise times to show a trajectory of molecular changes.…”

Sepsis: Precision-Based Medicine for Pregnancy and the Puerperium

“…As sepsis is such a heterogenous condition with multi-systemic impact, it is unlikely that a single biomarker would have significant sensitivity and specificity for the early diagnosis of sepsis; using multiple biomarkers may increase the yield and omic technologies may be a way to achieve this [100]. The “omics” approach has the potential to help identify “signature” biological markers that can be developed into clinical tools for diagnosis and prognosis.…”

“…The transcriptome of immune cells from patients with sepsis theoretically could provide an early diagnostic tool for sepsis. The set of mRNA markers it represents known as the “transcriptomic signature”, may demonstrate the earliest change triggered by the infective process before translation of the relevant proteins [100]. Indeed, there is emerging evidence that a transcriptomic signature is a reflection of the host’s sepsis response, and has prognostic value, particularly regarding mortality risk, and this is independent of the causative pathogen or site of infection [104,105].…”

Transcriptome for the breast muscle of Jinghai yellow chicken at early growth stages

“…With the advent of the post-genomic era, transcriptomics, proteomics, metabolomics, and other omics technologies have emerged one after another (Prucha, Zazula & Russwurm, 2018). The transcriptomic technology has developed rapidly and has been increasingly used in recent years.…”