4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, ATTIKON University Hospital, Athens, Greece.
4 Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, ATTIKON University Hospital, Athens, Greece.
Expert Rev Mol Diagn. 2021 Jan;21(1):17-29. doi: 10.1080/14737159.2020.1851199. Epub 2020 Dec 10.
: This review aims to summarize current progress of the last ten years in the development of biomarkers used for classifying the immune response of the septic host and for monitoring the efficacy of the applied adjunctive immunotherapy.: An extensive search of the literature was performed. In this review the authors discuss available biomarkers of host immune response in sepsis toward two directions; immunosuppression and hyperinflammation. Ferritin, sCD163, sIL-2 ra, and IL-18 may help in the diagnosis of macrophage activation syndrome (MAS) complicating sepsis whereas lymphopenia, decreased HLA-DR expression on monocytes, overexpression of Programmed cell death protein-1 (PD-1)/Programmed death-ligand 1 (PD-L1) and IL-10 are indicators of sepsis-induced immunosuppression. Novel approaches in the classification of immune state in sepsis include Myeloid-Derived Suppressor Cells (MDSC) and specific endotypes, defined by gene expression and molecular techniques.: HLA-DR and ferritin are the most commonly used biomarkers to monitor immunomodulation in clinical practice whereas developing specific sepsis endotypes is the future target. New immunotherapy trials in sepsis need to incorporate biomarkers for a personalized treatment.
: 这篇综述旨在总结过去十年中用于分类脓毒症宿主免疫反应和监测应用辅助免疫治疗效果的生物标志物的最新进展。进行了广泛的文献检索。在这篇综述中，作者讨论了脓毒症宿主免疫反应的现有生物标志物，主要针对两个方向：免疫抑制和过度炎症。铁蛋白、sCD163、sIL-2ra 和 IL-18 可能有助于诊断合并脓毒症的巨噬细胞活化综合征（MAS），而淋巴细胞减少、单核细胞 HLA-DR 表达降低、程序性细胞死亡蛋白-1（PD-1）/程序性死亡配体 1（PD-L1）和 IL-10 的过度表达则是脓毒症诱导免疫抑制的指标。在脓毒症免疫状态分类的新方法中，包括髓源抑制细胞（MDSC）和特定的表型，通过基因表达和分子技术来定义。: HLA-DR 和铁蛋白是临床上最常用的监测免疫调节的生物标志物，而开发特定的脓毒症表型则是未来的目标。脓毒症的新免疫治疗试验需要结合生物标志物进行个体化治疗。
