Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Sci Rep. 2021 Oct 21;11(1):20794. doi: 10.1038/s41598-021-99595-0.
Sepsis is a potentially fatal condition caused by infection. It is frequently difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS), often resulting in poor prognoses and the misuse of antibiotics. Hence, highly sensitive and specific biomarkers are needed to differentiate sepsis from SIRS. Urine samples were collected and segregated by group (a sepsis group, a SIRS group, and a healthy control group). iTRAQ was used to identify the differentially expressed proteins among the three groups. The identified proteins were measured by ELISA in urine samples. Finally, all the acquired data were analyzed in SPSS. C-reactive protein, leucine-rich alpha glycoprotein-1 and serum amyloid A (SAA) protein were differentially expressed among the three groups. The adjusted median concentrations of urinary C-reactive protein were 1337.6, 358.7, and 2.4 in the sepsis, SIRS, and healthy control groups, respectively. The urinary leucine-rich alpha glycoprotein-1 levels in these three groups were 1614.4, 644.5, and 13.6, respectively, and the levels of SAA were 6.3, 2.9, and 0.07, respectively. For all three of these measures, the sepsis group had higher levels than the SIRS group (P < 0.001), and the SIRS group had higher levels than the healthy control group. When combined, the three biomarkers had a sensitivity of 0.906 and a specificity of 0.896 in distinguishing sepsis from SIRS. Urinary C-reactive protein, urinary leucine-rich alpha glycoprotein-1 and urinary SAA have diagnostic value in cases of sepsis. This initial study suggests the possibility of improved differential diagnosis between sepsis and systemic inflammatory response syndrome; additional confirmation is necessary to corroborate the findings.
脓毒症是一种由感染引起的潜在致命疾病。它经常难以与全身炎症反应综合征（SIRS）区分，导致预后不佳和抗生素滥用。因此，需要高度敏感和特异的生物标志物来区分脓毒症和 SIRS。收集尿液样本并按组分离（脓毒症组、SIRS 组和健康对照组）。使用 iTRAQ 鉴定三组之间差异表达的蛋白质。通过 ELISA 在尿样中测量鉴定出的蛋白质。最后，所有获得的数据均在 SPSS 中进行分析。在三组中，C 反应蛋白、富含亮氨酸的α-2 糖蛋白-1 和血清淀粉样蛋白 A（SAA）蛋白表达存在差异。脓毒症、SIRS 和健康对照组尿液 C 反应蛋白的调整中位数浓度分别为 1337.6、358.7 和 2.4ng/ml。这三组的尿富含亮氨酸的α-2 糖蛋白-1 水平分别为 1614.4、644.5 和 13.6ng/ml，SAA 水平分别为 6.3、2.9 和 0.07ng/ml。对于所有这三种方法，脓毒症组的水平均高于 SIRS 组（P<0.001），SIRS 组的水平高于健康对照组。三种生物标志物联合使用时，区分脓毒症和 SIRS 的敏感性为 0.906，特异性为 0.896。尿液 C 反应蛋白、尿液富含亮氨酸的α-2 糖蛋白-1 和尿液 SAA 在脓毒症诊断中具有诊断价值。本初步研究提示，在脓毒症和全身炎症反应综合征之间进行鉴别诊断可能会有所改善；需要进一步确认以证实这些发现。
