Muñoz Balam, Suárez-Sánchez Rocío, Hernández-Hernández Oscar, Franco-Cendejas Rafael, Cortés Hernán, Magaña Jonathan J
Department of Bioengineering, Tecnológico de Monterrey, Campus Ciudad de México, Mexico City, Mexico.
Laboratory of Genomic Medicine, Department of Genetics, National Center for Research and Care for Burns (CENIAQ), Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City, Mexico.
Burns. 2019 Feb;45(1):16-31. doi: 10.1016/j.burns.2018.04.016. Epub 2018 May 23.
Sepsis is a life-threatening organ-dysfunction condition caused by a dysregulated response to an infectious condition that can cause complications in patients with major trauma. Burns are one of the most destructive forms of trauma; despite the improvements in medical care, infections remain an important cause of burn injury-related mortality and morbidity, and complicated sepsis predisposes patients to diverse complications such as organ failure, lengthening of hospital stays, and increased costs. Accurate diagnosis and early treatment of sepsis may have a beneficial impact on clinical outcome of burn-injured patients. In this review, we offer a comprehensive description of the current and traditional markers used as indicative of sepsis in burned patients. However, although these are markers of the inflammatory post-burn response, they usually fail to predict sepsis in severely burned patients due to that they do not reflect the severity of the infection. Identification and measurement of biomarkers in early stages of infection is important in order to provide timely response and effective treatment of burned patients. Therefore, we compiled important experimental evidence, demonstrating novel biomarkers, including molecular markers such as genomic DNA variations, alterations of transcriptome profiling (mRNA, miRNAs, lncRNAs and circRNAs), epigenetic markers, and advances in proteomics and metabolomics. Finally, this review summarizes next-generation technologies for the identification of markers for detection of sepsis after burn injuries.
脓毒症是一种由对感染状况的失调反应引起的危及生命的器官功能障碍病症，可导致重大创伤患者出现并发症。烧伤是最具破坏性的创伤形式之一；尽管医疗护理有所改善，但感染仍然是烧伤相关死亡率和发病率的重要原因，而复杂性脓毒症会使患者易患多种并发症，如器官衰竭、住院时间延长和费用增加。准确诊断和早期治疗脓毒症可能对烧伤患者的临床结局产生有益影响。在本综述中，我们全面描述了目前用于指示烧伤患者脓毒症的传统标志物。然而，尽管这些是烧伤后炎症反应的标志物，但由于它们不能反映感染的严重程度，通常无法预测严重烧伤患者的脓毒症。在感染早期识别和测量生物标志物对于及时应对和有效治疗烧伤患者很重要。因此，我们汇集了重要的实验证据，展示了新的生物标志物，包括分子标志物，如基因组DNA变异、转录组谱（mRNA、miRNA、lncRNA和circRNA）改变、表观遗传标志物，以及蛋白质组学和代谢组学的进展。最后，本综述总结了用于识别烧伤后脓毒症检测标志物的下一代技术。
