University of Maryland, School of Pharmacy, Department of Pharmaceutical Sciences, Baltimore, MD, USA.
Nanotheranostics. 2024 Feb 25;8(3):270-284. doi: 10.7150/ntno.94071. eCollection 2024.
Though there have been developments in clinical care and management, early and accurate diagnosis and risk stratification are still bottlenecks in septic shock patients. Since septic shock is multifactorial with patient-specific underlying co-morbid conditions, early assessment of sepsis becomes challenging due to variable symptoms and clinical manifestations. Moreover, the treatment strategies are traditionally based on their progression and corresponding clinical symptoms, not personalized. The complex pathophysiology assures that a single biomarker cannot identify, stratify, and describe patients affected by septic shock. Traditional biomarkers like CRP, PCT, and cytokines are not sensitive and specific enough to be used entirely for a patient's diagnosis and prognosis. Thus, the need of the hour is a sensitive and specific biomarker after comprehensive analysis that may facilitate an early diagnosis, prognosis, and drug development. Integration of clinical data with metabolomics would provide means to understand the patient's condition, stratify patients better, and predict the clinical outcome.
尽管在临床护理和管理方面已经取得了一些进展,但早期准确的诊断和风险分层仍然是脓毒性休克患者的瓶颈。由于脓毒性休克具有多因素性,且患者存在特定的合并症,因此由于症状和临床表现的多变性,早期评估脓毒症具有挑战性。此外,传统的治疗策略基于其进展和相应的临床症状,而不是个性化的。复杂的病理生理学确保了单一生物标志物无法识别、分层和描述受脓毒性休克影响的患者。传统的生物标志物,如 CRP、PCT 和细胞因子,不够敏感和特异,不能完全用于患者的诊断和预后。因此,当前的迫切需要是一种经过综合分析的敏感和特异的生物标志物,以促进早期诊断、预后和药物开发。将临床数据与代谢组学相结合,将为了解患者病情、更好地分层患者和预测临床结局提供手段。