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Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.QSOFA评分与全身炎症反应综合征(SIRS)标准作为急诊科脓毒症筛查机制的比较。
Am J Emerg Med. 2017 Nov;35(11):1730-1733. doi: 10.1016/j.ajem.2017.07.001. Epub 2017 Jul 6.
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Cytokine storm and sepsis disease pathogenesis.细胞因子风暴与脓毒症疾病发病机制。
Semin Immunopathol. 2017 Jul;39(5):517-528. doi: 10.1007/s00281-017-0639-8. Epub 2017 May 29.
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Time to Treatment and Mortality during Mandated Emergency Care for Sepsis.脓毒症强制紧急治疗的治疗时间与死亡率
N Engl J Med. 2017 Jun 8;376(23):2235-2244. doi: 10.1056/NEJMoa1703058. Epub 2017 May 21.
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Increased Time to Initial Antimicrobial Administration Is Associated With Progression to Septic Shock in Severe Sepsis Patients.严重脓毒症患者初始抗菌药物给药时间延长与进展为感染性休克相关。
Crit Care Med. 2017 Apr;45(4):623-629. doi: 10.1097/CCM.0000000000002262.
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Plasma cytokine levels predict response to corticosteroids in septic shock.血浆细胞因子水平可预测脓毒性休克对皮质类固醇的反应。
Intensive Care Med. 2016 Dec;42(12):1970-1979. doi: 10.1007/s00134-016-4338-z. Epub 2016 Apr 12.
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The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).《脓毒症及脓毒性休克第三次国际共识定义(脓毒症-3)》
JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.
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Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations.评估全球医院治疗脓毒症的发病率和死亡率。当前的估计和局限性。
Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72. doi: 10.1164/rccm.201504-0781OC.
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Adequate antibiotic therapy prior to ICU admission in patients with severe sepsis and septic shock reduces hospital mortality.在严重脓毒症和脓毒性休克患者入住重症监护病房(ICU)之前进行充分的抗生素治疗可降低医院死亡率。
Crit Care. 2015 Aug 27;19(1):302. doi: 10.1186/s13054-015-1000-z.
9
Interleukin-3 amplifies acute inflammation and is a potential therapeutic target in sepsis.白细胞介素-3 放大急性炎症反应,是脓毒症的潜在治疗靶点。
Science. 2015 Mar 13;347(6227):1260-5. doi: 10.1126/science.aaa4268.
10
Pleural innate response activator B cells protect against pneumonia via a GM-CSF-IgM axis.胸膜固有反应激活 B 细胞通过 GM-CSF-IgM 轴预防肺炎。
J Exp Med. 2014 Jun 2;211(6):1243-56. doi: 10.1084/jem.20131471. Epub 2014 May 12.

用于快速即时脓毒症诊断的集成生物传感器。

Integrated Biosensor for Rapid and Point-of-Care Sepsis Diagnosis.

机构信息

Department of Surgery , University Hospital of Erlangen , 91054 Erlangen , Germany.

Department of Systems Biology , Harvard Medical School , Boston , Massachusetts 02115 , United States.

出版信息

ACS Nano. 2018 Apr 24;12(4):3378-3384. doi: 10.1021/acsnano.7b08965. Epub 2018 Mar 20.

DOI:10.1021/acsnano.7b08965
PMID:29533646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6019292/
Abstract

Sepsis is an often fatal condition that arises when the immune response to an infection causes widespread systemic organ injury. A critical unmet need in combating sepsis is the lack of accurate early biomarkers that produce actionable results in busy clinical settings. Here, we report the development of a point-of-care platform for rapid sepsis detection. Termed IBS (integrated biosensor for sepsis), our approach leverages (i) the pathophysiological role of cytokine interleukin-3 (IL-3) in early sepsis and (ii) a hybrid magneto-electrochemical sensor for IL-3 detection. The developed platform produces test results within 1 h from native blood samples and detects IL-3 at a sensitivity of <10 pg/mL; this performance is >5-times faster and >10-times more sensitive than conventional enzyme-linked immunoadsorbent assays, the current gold standard. Using clinical samples, we show that elevated plasma IL-3 levels are associated with high organ failure rate and thus greater risk of mortality, confirming the potential of IL-3 as a sepsis diagnostic biomarker. With further system development ( e. g., full automation, data security measures) and rigorous validation studies, the compact and fast IBS could be a practical clinical tool for timely diagnosis and proactive treatment of sepsis.

摘要

脓毒症是一种常见的致命病症,它是由感染引起的免疫反应导致全身广泛的器官损伤引起的。在对抗脓毒症方面,一个关键的未满足需求是缺乏准确的早期生物标志物,这些标志物在繁忙的临床环境中能提供可操作的结果。在这里,我们报告了一种用于快速脓毒症检测的即时护理平台的开发。我们称之为 IBS(脓毒症集成生物传感器),我们的方法利用了 (i) 细胞因子白细胞介素-3 (IL-3) 在早期脓毒症中的病理生理作用,以及 (ii) 用于 IL-3 检测的混合磁电化学传感器。该开发的平台可在 1 小时内从原始血液样本中产生测试结果,并以 <10 pg/mL 的灵敏度检测 IL-3;这种性能比传统的酶联免疫吸附测定(目前的金标准)快 5 倍以上,灵敏度高 10 倍以上。使用临床样本,我们表明,血浆中升高的 IL-3 水平与高器官衰竭率相关,因此死亡率更高,这证实了 IL-3 作为脓毒症诊断生物标志物的潜力。通过进一步的系统开发(例如,完全自动化、数据安全措施)和严格的验证研究,紧凑且快速的 IBS 可能成为脓毒症及时诊断和主动治疗的实用临床工具。