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儿科脓毒症生物标志物的进展——我们目前了解到了什么?

Advances in pediatric sepsis biomarkers - what have we learnt so far?

作者信息

Su Wen, Fan Miao, Shen Wei, Wang Xinyu, Li Rubo, Lu Lu, Wu Jie, Yao Kaihu, Wang Quan, Qian Suyun, Yu Dan

机构信息

Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Center for Children's Health, Beijing, China.

Senior Department of Gastroenterology, the First Medical Center of PLA General Hospital, Beijing, China.

出版信息

Expert Rev Mol Diagn. 2025 May;25(5):183-198. doi: 10.1080/14737159.2025.2500656. Epub 2025 May 5.

Abstract

INTRODUCTION

Sepsis is a systemic immune dysregulation syndrome triggered by secondary infection in the host, with diagnosis based on the updated Phoenix criteria and characterized by multi-organ failure as its core pathological manifestation. It is a significant global health challenge due to its increasing incidence and high mortality rates. Recent advancements in biomarker research provide promising tools for improving early diagnosis and timely intervention, essential for better patient outcomes.

AREAS COVERED

This review examines the latest developments in pediatric sepsis biomarkers, categorized by inflammation, metabolism, organ damage, and non-coding RNAs (miRNAs, LncRNAs). We discuss the advancements in each category, highlighting the integration of diverse biomarkers and advanced technologies to enhance diagnostics, personalize therapy, and improve patient stratification.

EXPERT OPINION

Given the limited specificity and sensitivity of current markers like CRP and PCT, multicenter studies are crucial for validating new biomarkers and for developing comprehensive panel markers that combine multiple diagnostic indicators. It is also important to consider the variability in host responses to different pathogens when identifying biomarkers based on host-pathogen interactions. To advance personalized medicine, future research may prioritize the identification of specific diagnostic biomarkers for pediatric sepsis, tailored to different pathogens.

摘要

引言

脓毒症是一种由宿主继发感染引发的全身性免疫失调综合征,依据最新的菲尼克斯标准进行诊断,其核心病理表现为多器官功能衰竭。由于其发病率不断上升且死亡率高,它是一项重大的全球健康挑战。生物标志物研究的最新进展为改善早期诊断和及时干预提供了有前景的工具,这对改善患者预后至关重要。

涵盖领域

本综述探讨了儿科脓毒症生物标志物的最新进展,按炎症、代谢、器官损伤和非编码RNA(微小RNA、长链非编码RNA)进行分类。我们讨论了每个类别中的进展,强调了多种生物标志物和先进技术的整合,以加强诊断、实现治疗个性化并改善患者分层。

专家观点

鉴于当前如CRP和PCT等标志物的特异性和敏感性有限,多中心研究对于验证新的生物标志物以及开发结合多种诊断指标的综合标志物组至关重要。在基于宿主 - 病原体相互作用识别生物标志物时,考虑宿主对不同病原体反应的变异性也很重要。为了推进个性化医疗,未来研究可能会优先识别针对儿科脓毒症的特定诊断生物标志物,针对不同病原体进行定制。

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