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脓毒症生物标志物:进展与临床应用——叙述性综述。

Sepsis Biomarkers: Advancements and Clinical Applications-A Narrative Review.

机构信息

Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.

School of Chinese Materia Medica, Guangdong Pharmaceutical University, Guangzhou 510006, China.

出版信息

Int J Mol Sci. 2024 Aug 19;25(16):9010. doi: 10.3390/ijms25169010.


DOI:10.3390/ijms25169010
PMID:39201697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11354379/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c22f/11354379/da05e89d6577/ijms-25-09010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c22f/11354379/da05e89d6577/ijms-25-09010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c22f/11354379/da05e89d6577/ijms-25-09010-g001.jpg

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引用本文的文献

[1]
Diagnostic utility of sepsis screening tools, procalcitonin, and C-reactive protein in nosocomial fever of unknown origin.

World J Crit Care Med. 2025-9-9

[2]
Association between the nutritional inflammation index and mortality among patients with sepsis: insights from traditional methods and machine learning-based mortality prediction.

BMC Infect Dis. 2025-8-14

[3]
Recent Advances in Micro- and Nano-Enhanced Intravascular Biosensors for Real-Time Monitoring, Early Disease Diagnosis, and Drug Therapy Monitoring.

Sensors (Basel). 2025-8-7

[4]
Combined Analysis of Transcriptome and Mendelian Randomization Reveals and as Biomarkers Related to Glucose Metabolism in Sepsis.

J Inflamm Res. 2025-7-30

[5]
Is "pre-sepsis" the new sepsis? A narrative review.

PLoS Pathog. 2025-7-31

[6]
Biomarkers to guide sepsis management.

Ann Intensive Care. 2025-7-21

[7]
Maternal sepsis due to Bacteroides fragilis: a case report and review of the literature.

J Med Case Rep. 2025-7-15

[8]
Point of care sepsis diagnosis: Exploring microfluidic techniques for sample preparation, biomarker isolation, and detection.

Biomicrofluidics. 2025-7-1

[9]
A label-free electrochemical immunosensor on gold-printed electrode for the electrochemical detection of C-reactive protein from blood samples.

Mikrochim Acta. 2025-6-20

[10]
Biomarkers as Beacons: Illuminating Sepsis-Associated Hepato-Renal Injury.

Int J Mol Sci. 2025-5-18

本文引用的文献

[1]
Investigation of Serum Endocan Levels in SARS-CoV-2 Patients.

Int J Mol Sci. 2024-3-6

[2]
Serial monitoring of pancreatic stone protein for the detection of sepsis in intensive care unit patients with complicated abdominal surgery: A prospective, longitudinal cohort study.

J Crit Care. 2024-8

[3]
PAI-1 as a critical factor in the resolution of sepsis and acute kidney injury in old age.

Front Cell Dev Biol. 2024-1-18

[4]
Accuracy of procalcitonin for diagnosing sepsis in adult patients admitted to the emergency department: a systematic review and meta-analysis.

Syst Rev. 2024-1-22

[5]
LncRNA HOTTIP as a diagnostic biomarker for acute respiratory distress syndrome in patients with sepsis and to predict the short-term clinical outcome: a case-control study.

BMC Anesthesiol. 2024-1-18

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Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis.

Open Med (Wars). 2023-12-31

[7]
Circ_0006944 aggravates LPS-induced HK2 cell injury via modulating miR-205-5p/UBL4A pathway.

Autoimmunity. 2023-12

[8]
Early Diagnostic Markers of Late-Onset Neonatal Sepsis.

Pediatr Rep. 2023-9-20

[9]
Septic encephalopathy in the elderly - biomarkers of potential clinical utility.

Front Cell Neurosci. 2023-9-7

[10]
Prognostic value of platelet combined with serum procalcitonin in patients with sepsis.

Medicine (Baltimore). 2023-8-25

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