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Table 9 Other biomarkers identified in the literature search (with some selected references)

From: Sepsis biomarkers: a review

Sepsis marker Evaluated in experimental studies Evaluated in clinical studies Evaluated as a prognostic factor Comment
Alpha2 macroglobulin [196, 208]    
Albumin [209]    
Anti-endotoxin core antibodies (EndoCab) [210]   A Distinguished between survivors and non-survivors at 28 days
Apolipoprotein CI [211213]   C Distinguished between survivors and non-survivors at 28 days
Bcl-2 [214]   A Distinguished between survivors and non-survivors at 28 days
Beta-thromboglobulin [215]   B Predicted response to therapy
Caspase-1 [216]   A   Increased in septic shock compared with healthy controls
Ceramide [217]   B √** Predicted development of MOF
Cholesterol [218]   C Distinguished between survivors and non-survivors at 28 days in patients with severe sepsis
Complement (C3, C4, C5a levels) [219, 220]   B(m) Distinguished between survivors and non-survivors at 28 days
Terminal complement complex [221]    
Dendritic cell [222, 223] B Distinguished between survivors and non-survivors at 28 days, correlated with SOFA score
Dipeptidylpeptidase [224]   B   Decreased in sepsis compared with healthy controls
Diiodotyrosine (DIT) [225]   C Increased in sepsis compared with non-septic critically ill
Eicosanoid [226, 227] A(s) Correlated with SAPS score, predicted response to therapy
Elastase [228, 229] C(s) Predicted response to therapy in patients with joint infections
Elastase-a1-antitrypsin complex [230, 231]   C Predicted response to therapy
Erythropoietin [232]   A Distinguished between survivors and non-survivors at 28 days in patients with septic shock, correlated with lactate levels
F2 isoprostanes [233]   B(m) Increased in infected diabetic patients compared with non-infected diabetics
Fatty acid amide hydrolase [234]   A Decreased in sepsis compared with healthy controls
Free DNA [235]   B √* Distinguished between survivors and non-survivors at 28 days
G-CSF and GM-CSF [236, 237]   B √** Distinguished between survivors and non-survivors at 28 days
Gelsolin [238]   B(s) Distinguished between survivors and non-survivors at 28 days
Ghrelin [239, 240]    
Growth arrest specific protein (Gas) 6 [241]   B Correlated with APACHE II score in patients with severe sepsis
Heat shock protein (HSP)70, 72, 73, 90 and 32 [242245] C(s)   Increased in sepsis compared with healthy controls
HDL cholesterol   C √** Distinguished between survivors and non-survivors at 28 days, predicted polonged ICU length of stay
HLA-G5 protein (soluble) [246]   C(m) √* Distinguished between survivors and non-survivors at 28 days in patients with septic shock
H2S [247]    
Hyaluronan [248, 249] B   Distinguished between survivors and non-survivors at 28 days in patients with septic shock
Hydrolytic IgG antibodies [250]   B Distinguished between survivors and non-survivors at 28 days, correlation with SAPS II score
Inter-alpha inhibitor proteins (IalphaIp) [251]   C Predicted development of MOF
Intracellular nitric oxide in leukocyte [252]   B Negatively correlated with SOFA score
IP-10 [30]   C   Increased in sepsis compared with healthy controls
Lactate [253, 254]   C Distinguished between survivors and non-survivors at 28 days, predicted response to therapy
Lactoferrin [255, 256] C(s)   Predicted response to therapy
Leptin [240, 257] B No prognostic value, higher in septic than in non-septic ICU patients
Serum lysozyme (enzyme activity) [258]   B(s)   Increased in sepsis compared with healthy controls
Matrix-metalloproteinase (MMP)-9 [259]   B   Increased in severe sepsis compared with healthy controls
Microparticles (cell derived) [252]   B Distinguished between survivors and non-survivors at 28 days, correlation with SOFA score
Neurotensin [260]    
Nitrate excretion (urinary and expired) [261]    
Nociceptin/orphanin FQ (N/OFQ) [262]   A Distinguished between survivors and non-survivors at 28 days
NF-κB (activity and expression) [263]   B √** Distinguished between survivors and non-survivors at 28 days in patients with severe sepsis, correlation with APACHE II score
Nucleosomes [264]   C   Distinguished between survivors and non-survivors at 28 days
Peptidoglycan [265]   B(s) Increased in sepsis compared with healthy controls
PlGF [266]    
Plasma amino acids [267269]   A Distinguished between survivors and non-survivors at 28 days, predicted development of MOF
Plasma fibronectin [270]   B Increased in sepsis compared with healthy controls
Plasmin alpha2-antiplasmin complex [271]   C   Predicted development of MOF
Renin [272]   B Correlation with lactate levels in patients with septic shock
Resistin [273]   C Correlation with APACHE II score in patients with severe sepsis
Selenium [274]   C Correlation with APACHE II in patients with severe sepsis
Selenoprotein P [275]   B   Decraesed in sepsis compared with healthy controls
Serum bicarbonate [276]   A(m) Predicted development of septic shock in neutropenic patients
Sphingomyelinase (enzyme activity) [277]   A   Distinguished between survivors and non-survivors at 28 days in patients with severe sepsis
Sulfite [278] B(m) Predicted response to therapy
Transforming growth factor (TGF)-β1 [279, 280] A(m)   Distinguished between survivors and non-survivors at 28 days
TIMP-1 and 2 [259]   B √* Distinguished between survivors and non-survivors at 28 days
TIMP-3 [281]    
Uric acid [282]   C(s) Decreased in postoperative patients with sepsis compared with those with no sepsis
Urinary 8-OhdG [283]   C Distinguished between survivors and non-survivors at 28 days
Urinary bilirubin oxidative metabolites (BOMs) [284]   A Correlation with APACHE II score
Annexin V binding [285] B(s)   Increased in sepsis compared with healthy controls
Xanthine oxidase (activity) [286]   C Distinguished between survivors and non-survivors at 28 days
  1. *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.
  2. APACHE: acute physiology and chronic health evalution; G-CSF: granulocyte colony-stimulating factor; GM-CSF: granulocyte-macrophage colony stimulating factor; MOF: multiple organ failure; NF-κB: nuclear factor kappa B; PlGF: placental growth factor; SAPS: simplified acute physiology score; SOFA: sequential organ failure assessment; TIMP: tissue inhibitor of metalloproteinase.