Herrmann I K, Bertazzo S, O'Callaghan D J P, Schlegel A A, Kallepitis C, Antcliffe D B, Gordon A C, Stevens M M
Department of Materials, Department of Bioengineering and Institute of Biomedical Engineering, Imperial College London, Prince Consort Road, London, SW7 2AZ, UK.
Nanoscale. 2015 Aug 28;7(32):13511-20. doi: 10.1039/c5nr01851j. Epub 2015 Jul 23.
Sepsis is a severe medical condition and a leading cause of hospital mortality. Prompt diagnosis and early treatment has a significant, positive impact on patient outcome. However, sepsis is not always easy to diagnose, especially in critically ill patients. Here, we present a conceptionally new approach for the rapid diagnostic differentiation of sepsis from non-septic intensive care unit patients. Using advanced microscopy and spectroscopy techniques, we measure infection-specific changes in the activity of nano-sized cell-derived microvesicles to bind bacteria. We report on the use of a point-of-care-compatible microfluidic chip to measure microvesicle-bacteria aggregation and demonstrate rapid (≤1.5 hour) and reliable diagnostic differentiation of bacterial infection from non-infectious inflammation in a double-blind pilot study. Our study demonstrates the potential of microvesicle activities for sepsis diagnosis and introduces microvesicle-bacteria aggregation as a potentially useful parameter for making early clinical management decisions.
脓毒症是一种严重的病症，也是医院死亡率的主要原因。及时诊断和早期治疗对患者的预后有显著的积极影响。然而，脓毒症并不总是易于诊断，尤其是在危重病患者中。在此，我们提出一种全新的概念性方法，用于快速诊断区分脓毒症患者与非脓毒症重症监护病房患者。我们使用先进的显微镜和光谱技术，测量纳米级细胞衍生微泡结合细菌活性中特定于感染的变化。我们报告了使用一种与床旁检测兼容的微流控芯片来测量微泡-细菌聚集情况，并在一项双盲试点研究中证明了能够快速（≤1.5小时）且可靠地诊断区分细菌感染与非感染性炎症。我们的研究证明了微泡活性在脓毒症诊断中的潜力，并引入微泡-细菌聚集作为一个可能有助于做出早期临床管理决策的有用参数。
