Department of Critical Care Medicine, West China Hospital, Sichuan University and Institute of Critical Care Medicine, Chengdu, Sichuan Province, China.
Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Shock. 2024 Jan 1;61(1):97-104. doi: 10.1097/SHK.0000000000002199.
Sepsis is an organ dysfunction caused by a dysregulated host response to infection and remains an ongoing threat to human health worldwide. Septic shock is the most severe subset of sepsis as characterized by abnormalities in cells, circulation, and metabolism. As a time-dependent condition, early recognition allowing appropriate therapeutic measures to be started in a timely manner becomes the most effective way to improve prognosis. However, because of the lack of a criterion standard, most diagnoses merely rely on medical history, empirical diagnosis, and blood culture results. Gene expression profiles have specific diagnostic value, as they reflect a subjective host response to pathogens. We propose a method, Condition Control based on Real-life Medical Scenarios, to control for factors in realistic medical scenarios. Restricted variables are used as much as possible to identify unique differential genes and progressively test their diagnostic value by relaxing restrictions. In total, three data sets were included in the study; the first two data sets were from the Gene Expression Omnibus database, and the third involved patients who were diagnosed with sepsis or septic shock within 7 days of admission to the intensive care unit at West China Hospital of Sichuan University from 2020 to 2021. DDX47 showed preferable diagnostic value in various scenarios, especially in patients with common infections or sepsis and septic shock. Here we also show that hub genes may regulate immune function and immune cell counts through the interaction of different apoptotic pathways and immune checkpoints based on the high correlation. DDX47 is closely associated with B cells according to single-cell sequencing results.
脓毒症是一种由宿主对感染的失调反应引起的器官功能障碍,仍然是全球范围内人类健康的持续威胁。感染性休克是脓毒症最严重的亚组,其特征是细胞、循环和代谢异常。作为一种时间依赖性疾病,早期识别并及时开始适当的治疗措施是改善预后的最有效方法。然而,由于缺乏标准,大多数诊断仅仅依赖于病史、经验性诊断和血液培养结果。基因表达谱具有特定的诊断价值,因为它们反映了宿主对病原体的主观反应。我们提出了一种方法,基于真实医疗场景的条件控制,以控制现实医疗场景中的因素。尽可能使用受限变量来识别独特的差异基因,并通过放宽限制逐步测试它们的诊断价值。总共纳入了三个数据集进行研究;前两个数据集来自基因表达综合数据库,第三个数据集涉及 2020 年至 2021 年期间在四川大学华西医院重症监护病房住院 7 天内被诊断为脓毒症或感染性休克的患者。在各种情况下,DDX47 均显示出较好的诊断价值,尤其是在患有常见感染或脓毒症和感染性休克的患者中。根据高相关性,我们还表明,枢纽基因可能通过不同的凋亡途径和免疫检查点的相互作用来调节免疫功能和免疫细胞计数。根据单细胞测序结果,DDX47 与 B 细胞密切相关。