Department of Biotechnology, Parul Institute of Technology, Parul University, Vadodara, Gujarat, India.
Department of Life Science, Parul Institute of Applied Science, Parul University, Vadodara, Gujarat, India.
Clin Chim Acta. 2024 Aug 15;562:119891. doi: 10.1016/j.cca.2024.119891. Epub 2024 Jul 26.
Sepsis is a life-threatening condition characterized by dysregulated host response to infection leading to organ dysfunction. Despite advances in understanding its pathology, sepsis remains a global health concern and remains a major contributor to mortality. Timely identification is crucial for improving clinical outcomes, as delayed treatment significantly impacts survival. Accordingly, biomarkers play a pivotal role in diagnosis, risk stratification, and management. This review comprehensively discusses various biomarkers in sepsis and their potential application in antimicrobial stewardship and risk assessment. Biomarkers such as white blood cell count, neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, C-reactive protein, interleukin-6, presepsin, and procalcitonin have been extensively studied for their diagnostic and prognostic value as well as in guiding antimicrobial therapy. Furthermore, this review explores the role of biomarkers in risk stratification, emphasizing the importance of identifying high-risk patients who may benefit from specific therapeutic interventions. Moreover, the review discusses the emerging field of transcriptional diagnostics and metagenomic sequencing. Advances in sequencing have enabled the identification of host response signatures and microbial genomes, offering insight into disease pathology and aiding species identification. In conclusion, this review provides a comprehensive overview of the current understanding and future directions of biomarker-based approaches in sepsis diagnosis, management, and personalized therapy.
脓毒症是一种危及生命的病症,其特征是宿主对感染的反应失调,导致器官功能障碍。尽管人们对其病理有了更多的了解,但脓毒症仍然是一个全球性的健康问题,仍然是导致死亡率的主要因素。及时识别是改善临床结果的关键,因为延迟治疗会显著影响生存率。因此,生物标志物在诊断、风险分层和管理中起着关键作用。这篇综述全面讨论了脓毒症中的各种生物标志物及其在抗菌药物管理和风险评估中的潜在应用。白细胞计数、中性粒细胞与淋巴细胞比值、红细胞沉降率、C 反应蛋白、白细胞介素 6、降钙素原前肽等生物标志物已被广泛研究,以评估其在诊断、预后以及指导抗菌治疗方面的价值。此外,本综述探讨了生物标志物在风险分层中的作用,强调了识别可能受益于特定治疗干预的高危患者的重要性。此外,该综述还讨论了转录诊断学和宏基因组测序等新兴领域。测序技术的进步使人们能够识别宿主反应特征和微生物基因组,深入了解疾病的病理机制,并有助于进行物种鉴定。总之,本综述全面概述了基于生物标志物的脓毒症诊断、管理和个体化治疗的现状和未来方向。