Di Raimondo Domenico, Pirera Edoardo, Rizzo Giuliana, Simonetta Irene, Musiari Gaia, Tuttolomondo Antonino
Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) "G. D'Alessandro", University of Palermo, Piazza delle Cliniche, 90100 Palermo, Italy.
Diagnostics (Basel). 2022 May 31;12(6):1355. doi: 10.3390/diagnostics12061355.
According to "Sepsis-3" consensus, sepsis is a life-threatening clinical syndrome caused by a dysregulated inflammatory host response to infection. A rapid identification of sepsis is mandatory, as the extent of the organ damage triggered by both the pathogen itself and the host's immune response could abruptly evolve to multiple organ failure and ultimately lead to the death of the patient. The most commonly used therapeutic strategy is to provide hemodynamic and global support to the patient and to rapidly initiate broad-spectrum empiric antibiotic therapy. To date, there is no gold standard diagnostic test that can ascertain the diagnosis of sepsis. Therefore, once sepsis is suspected, the presence of organ dysfunction can be assessed using the Sepsis-related Organ Failure Assessment (SOFA) score, although the diagnosis continues to depend primarily on clinical judgment. Clinicians can now rely on several serum biomarkers for the diagnosis of sepsis (e.g., procalcitonin), and promising new biomarkers have been evaluated, e.g., presepsin and adrenomedullin, although their clinical relevance in the hospital setting is still under discussion. Non-codingRNA, including long non-codingRNAs (lncRNAs), circularRNAs (circRNAs) and microRNAs (miRNAs), take part in a complex chain of events playing a pivotal role in several important regulatory processes in humans. In this narrative review we summarize and then analyze the function of circRNAs-miRNA-mRNA networks as putative novel biomarkers and therapeutic targets for sepsis, focusing only on data collected in clinical settings in humans.
根据“脓毒症-3”共识,脓毒症是一种由宿主对感染的炎症反应失调引起的危及生命的临床综合征。必须快速识别脓毒症,因为病原体本身和宿主免疫反应引发的器官损伤程度可能会突然发展为多器官功能衰竭并最终导致患者死亡。最常用的治疗策略是为患者提供血流动力学和全面支持,并迅速启动广谱经验性抗生素治疗。迄今为止,尚无能够确诊脓毒症的金标准诊断测试。因此,一旦怀疑脓毒症,可以使用脓毒症相关器官功能衰竭评估(SOFA)评分来评估器官功能障碍的存在,尽管诊断仍主要依赖于临床判断。临床医生现在可以依靠几种血清生物标志物来诊断脓毒症(例如降钙素原),并且已经评估了一些有前景的新生物标志物,例如可溶性髓系细胞触发受体-1和肾上腺髓质素,尽管它们在医院环境中的临床相关性仍在讨论中。非编码RNA,包括长链非编码RNA(lncRNA)、环状RNA(circRNA)和微小RNA(miRNA),参与了一系列复杂的事件,在人类的几个重要调节过程中发挥着关键作用。在这篇叙述性综述中,我们总结并分析了circRNA-miRNA-mRNA网络作为脓毒症潜在的新型生物标志物和治疗靶点的功能,仅关注在人类临床环境中收集的数据。