Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia.
Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia.
J Proteome Res. 2024 Apr 5;23(4):1328-1340. doi: 10.1021/acs.jproteome.3c00803. Epub 2024 Mar 21.
Delayed diagnosis of patients with sepsis or septic shock is associated with increased mortality and morbidity. UPLC-MS and NMR spectroscopy were used to measure panels of lipoproteins, lipids, biogenic amines, amino acids, and tryptophan pathway metabolites in blood plasma samples collected from 152 patients within 48 h of admission into the Intensive Care Unit (ICU) where 62 patients had no sepsis, 71 patients had sepsis, and 19 patients had septic shock. Patients with sepsis or septic shock had higher concentrations of neopterin and lower levels of HDL cholesterol and phospholipid particles in comparison to nonsepsis patients. Septic shock could be differentiated from sepsis patients based on different concentrations of 10 lipids, including significantly lower concentrations of five phosphatidylcholine species, three cholesterol esters, one dihydroceramide, and one phosphatidylethanolamine. The Supramolecular Phospholipid Composite (SPC) was reduced in all ICU patients, while the composite markers of acute phase glycoproteins were increased in the sepsis and septic shock patients within 48 h admission into ICU. We show that the plasma metabolic phenotype obtained within 48 h of ICU admission is diagnostic for the presence of sepsis and that septic shock can be differentiated from sepsis based on the lipid profile.
脓毒症或感染性休克患者的诊断延迟与死亡率和发病率增加有关。超高效液相色谱-质谱联用和核磁共振波谱法用于测量在入住重症监护病房（ICU）48 小时内采集的 152 名患者的血浆样本中的脂蛋白、脂质、生物胺、氨基酸和色氨酸代谢物的检测板，其中 62 名患者无脓毒症，71 名患者患有脓毒症，19 名患者患有感染性休克。与非脓毒症患者相比，患有脓毒症或感染性休克的患者的新蝶呤浓度更高，HDL 胆固醇和磷脂颗粒水平更低。脓毒性休克可根据 10 种脂质的不同浓度与脓毒症患者区分开来，包括五种磷脂酰胆碱、三种胆固醇酯、一种二氢神经酰胺和一种磷脂酰乙醇胺的浓度显著降低。所有 ICU 患者的超分子磷脂复合物（SPC）均减少，而在 ICU 入住 48 小时内，急性相糖蛋白的复合标志物在脓毒症和感染性休克患者中增加。我们表明，在 ICU 入住 48 小时内获得的血浆代谢表型可用于诊断脓毒症的存在，并且可以根据脂质谱将感染性休克与脓毒症区分开来。
