Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
School of Chinese Materia Medica, Guangdong Pharmaceutical University, Guangzhou 510006, China.
Int J Mol Sci. 2024 Aug 19;25(16):9010. doi: 10.3390/ijms25169010.
Sepsis is now defined as a life-threatening syndrome of organ dysfunction triggered by a dysregulated host response to infection, posing significant challenges in critical care. The main objective of this review is to evaluate the potential of emerging biomarkers for early diagnosis and accurate prognosis in sepsis management, which are pivotal for enhancing patient outcomes. Despite advances in supportive care, traditional biomarkers like C-reactive protein and procalcitonin have limitations, and recent studies have identified novel biomarkers with increased sensitivity and specificity, including circular RNAs, HOXA distal transcript antisense RNA, microRNA-486-5p, protein C, triiodothyronine, and prokineticin 2. These emerging biomarkers hold promising potential for the early detection and prognostication of sepsis. They play a crucial role not only in diagnosis but also in guiding antibiotic therapy and evaluating treatment effectiveness. The introduction of point-of-care testing technologies has brought about a paradigm shift in biomarker application, enabling swift and real-time patient evaluation. Despite these advancements, challenges persist, notably concerning biomarker variability and the lack of standardized thresholds. This review summarizes the latest advancements in sepsis biomarker research, spotlighting the progress and clinical implications. It emphasizes the significance of multi-biomarker strategies and the feasibility of personalized medicine in sepsis management. Further verification of biomarkers on a large scale and their integration into clinical practice are advocated to maximize their efficacy in future sepsis treatment.
脓毒症现在被定义为一种危及生命的器官功能障碍综合征,由宿主对感染的失调反应引发,对重症监护构成重大挑战。本综述的主要目的是评估新兴生物标志物在脓毒症管理中的早期诊断和准确预后中的潜力,这对于提高患者的治疗效果至关重要。尽管支持性治疗取得了进展,但 C 反应蛋白和降钙素原等传统生物标志物存在局限性,最近的研究已经确定了具有更高灵敏度和特异性的新型生物标志物,包括环状 RNA、HOXA 远端转录反义 RNA、miRNA-486-5p、蛋白 C、三碘甲状腺原氨酸和促动力素 2。这些新兴生物标志物在脓毒症的早期检测和预后判断方面具有很大的潜力。它们不仅在诊断中发挥关键作用,还可以指导抗生素治疗并评估治疗效果。即时检测技术的引入带来了生物标志物应用的范式转变,能够快速实时地评估患者。尽管取得了这些进展,但仍然存在挑战,特别是生物标志物的变异性和缺乏标准化阈值。本综述总结了脓毒症生物标志物研究的最新进展,强调了多生物标志物策略的重要性和脓毒症管理中个性化医学的可行性。提倡在更大规模上对生物标志物进行进一步验证,并将其整合到临床实践中,以最大限度地提高其在未来脓毒症治疗中的疗效。
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