Division Research and Landsteiner Laboratory, Department of Immunopathology, Sanquin Blood Supply, Amsterdam University Medical Center (UMC), Amsterdam, Netherlands.
Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, Amsterdam, Netherlands.
Front Immunol. 2021 May 17;12:631308. doi: 10.3389/fimmu.2021.631308. eCollection 2021.
Febrile patients, suffering from an infection, inflammatory disease or autoimmunity may present with similar or overlapping clinical symptoms, which makes early diagnosis difficult. Therefore, biomarkers are needed to help physicians form a correct diagnosis and initiate the right treatment to improve patient outcomes following first presentation or admittance to hospital. Here, we review the landscape of novel biomarkers and approaches of biomarker discovery. We first discuss the use of current plasma parameters and whole blood biomarkers, including results obtained by RNA profiling and mass spectrometry, to discriminate between bacterial and viral infections. Next we expand upon the use of biomarkers to distinguish between infectious and non-infectious disease. Finally, we discuss the strengths as well as the potential pitfalls of current developments. We conclude that the use of combination tests, using either protein markers or transcriptomic analysis, have advanced considerably and should be further explored to improve current diagnostics regarding febrile infections and inflammation. If proven effective when combined, these biomarker signatures will greatly accelerate early and tailored treatment decisions.
发热患者可能患有感染、炎症性疾病或自身免疫性疾病，其临床表现可能相似或重叠，这使得早期诊断变得困难。因此，需要生物标志物来帮助医生做出正确的诊断，并在首次就诊或住院时采取正确的治疗方法，以改善患者的预后。在这里，我们综述了新型生物标志物和生物标志物发现方法的研究进展。我们首先讨论了当前血浆参数和全血生物标志物的应用，包括 RNA 谱分析和质谱分析的结果，以区分细菌和病毒感染。接下来，我们扩展了生物标志物在鉴别感染性和非感染性疾病方面的应用。最后，我们讨论了当前研究进展的优势和潜在问题。我们得出结论，使用组合测试（包括蛋白质标志物或转录组分析）已经取得了很大进展，应该进一步探索以改善发热感染和炎症的当前诊断。如果联合使用被证明有效，这些生物标志物特征将极大地加速早期和针对性的治疗决策。
