Sepsis biomarkers: a review

Table 7 Biomarkers of organ dysfunction identified in the literature search (with some selected references)

Sepsis marker	Evaluated in experimental studies	Evaluated in clinical studies	Evaluated as a prognostic factor	Comment
Atrial natriuretic peptide (ANP) [168, 169]		C	√*	Distinguished between survivors and non-survivors at 28 days
Brain natriuretic peptide (BNP) [170–172]		B	√**	Distinguished between survivors and non-survivors at 28 days, correlated to APACHE II score
Carbomyl phosphate synthase (CPS)-1 [173]	√
Endothelin-1 and pro-endothelin-1 [174–177]	√	B	√	Distinguished between survivors and non-survivors at 28 days, correlated with SOFA score
Filterable cardiodepressant substance (FCS) [178]	√
Gc-globulin [179]		C(s)		Predicted development of MOF
Glial fibrillary acidic protein (GFAP) [180]		B	√	Increased in septic shock compared with healthy controls
alpha glutathione S-transferase (GST) [181]	√
Hepatocyte growth factor (HGF) (cellular and soluble) [182, 183]	√	C(m)		Predicted response to therapy
MEGX test [184, 185]	√	A	√	Correlated with SAPS II score
Myocardial angiotensin II [186]	√
NSE [187]		B	√	Correlated with SOFA scores
Pancreatitis-associated protein-I [188]	√
Pre B cell colony-enhancing factor (PBEF) [189]		A		Increased in sepsis compared with healthy controls
Protein S-100b [187, 190]	√	B	√	Distinguished between survivors and non-survivors at 28 days, correlated with SOFA score
Surfactant protein (A, B, C, D) [191, 192]	√	A		Increased in sepsis compared with healthy controls
Troponin [193]		B	√	Distinguished between survivors and non-survivors at 28 days, correlated with APACHE II score

*sensitivity and specificity of less than 90%; **sensitivity of more than 90% but specificity of less than 90%; A, Clinical study with less than 20 patients; B, Clinical study with 20 to 50 patients; C, Clinical study with more than 50 patients; (s), surgical patients only; (m), medical patients only.
APACHE: acute physiology and chronic health evaluation; MEGX: monoethylglycinexylidide; MOF: multiple organ failure; NSE: neuron-specific enolase; SAPS: simplified acute physiology score; SOFA: sequential organ failure assessment.

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