Table 1 Different roles of the biomarkers in sepsis
From: Biomarkers for sepsis: more than just fever and leukocytosis—a narrative review
Biomarker | Function | References |
|---|---|---|
Acute-phase proteins | ||
CRP, hsCRP | Response to infection and other inflammatory stimuli | |
Predictive for increased 28-day mortality in patients with sepsis | ||
Hyperinflammatory phenotype | ||
Complement | Prognosis of disease severity | |
Proteins | C5a can be predictive for DIC | |
PTX-3 | Discrimination of sepsis and septic shock | |
Diagnosis of sepsis and septic shock during the first week in the ICU | ||
Prediction of septic shock | ||
Cytokines and chemokines | ||
IL-10 | Hypoinflammatory phenotype | |
MCP-1 | It differentiates patients with septic shock from patients with sepsis | |
Mortality prognosis at 30 days and six months | ||
TNF-α, IL-1β, IL-6 | IL-6 all-cause mortality prognosis at 30 days and six months | |
IL-1β and IL-6 acute phase of sepsis | ||
It was increased in the hyperinflammatory phenotype | ||
Organ dysfunction prognosis | ||
DAMPs | ||
Calprotectin | PCT to distinguish between patients with sepsis and patients without sepsis in the ICU | [28] |
Predictive for 30-day mortality | ||
HMGB-1 | Worst prognosis and higher 28-day mortality | |
Endothelial cells and BBB markers | ||
Syndecan-1 | Increase related to sepsis severity | [34] |
Discriminative power for DIC and subsequent mortality | ||
VLA-3 (a3β1) | Indicative of sepsis | |
Discrimination of sepsis and SIRS | ||
Ang-1 | It stabilizes the endothelium and inhibits vascular leakage by constitutively activating the Tie-2 receptor | [79] |
Ang-2/Ang-1, Ang-1/Tie-2 ratio has a prognosis for 90-day mortality in sepsis and septic shock in the ICU higher than the PCT and SOFA score | ||
Independent and effective predictors of SOFA score changes | ||
Ang-2 | It can disrupt microvascular integrity by blocking the Tie-2 receptor, which results in vascular leakage | |
Individuals with septic shock had higher levels of Ang-2 than those with sepsis | ||
CLDN-5 | The absence of CLDN-5 may indicate damage to endothelial cells during sepsis | [31] |
OCLN | Increase related to sepsis severity and positive correlation with SOFA scores | |
Predictive of mortality | ||
The absence of OCLN in the cerebral microvascular endothelium was related to more severe disease and intense inflammatory response | ||
PAI-1 | Sepsis severity prognosis | |
Predictor of mortality | ||
An increase may indicate DIC | ||
sICAM-1 | Sepsis severity prognosis | |
Prognosis of 90-day mortality in patients with sepsis and septic shock in the ICU | ||
S100B | It is associated with delirium in septic shock | |
Prognosis of severe organ dysfunction | ||
Shortest survival in 180 days | ||
Diagnosis of sepsis-associated encephalopathy | ||
E-selectin | Sepsis severity prognosis | [33] |
Predicts mortality | ||
Increase related to SOFA and APACHE-II | ||
sFlt-1 | Prognosis of sepsis severity and SOFA score, | [33] |
The prognosis for morbidity and mortality | ||
sVCAM-1 | Prognosis of sepsis severity and 28-day mortality | |
Prognosis of 90-day mortality in patients with severe sepsis and septic shock in the ICU | ||
Risk of septic shock | ||
ZO-1 | Prognosis of sepsis severity and correlation with APACHE-II and SOFA scores | |
Predictor of mortality | ||
Diagnostic capability for MODS | ||
Gut permeability markers | ||
Citrulline | The decrease may indicate early acute bowel dysfunction | |
I-FABP | Risk of septic shock | [40] |
Indicates early intestinal damage in patients with sepsis and septic shock | ||
Zonulin | Indicates intestinal permeability during sepsis and SIRS | [39] |
D-lactic acid | Indicates early intestinal damage in patients with sepsis and septic shock | [40] |
Non-coding RNAs | ||
Lnc-MALAT1 | The distinction between septic and non-sepsis patients | |
Positive correlation with APACHE-II | ||
Sepsis severity prognosis | ||
High risk of ARDS | ||
Predictive for high mortality | ||
The increase can distinguish ARDS from non-ARDS | ||
lnc-MEG3 | The increase is predictive of sepsis | [43] |
28-day mortality risk | ||
miRNA | ||
miR-125a, miR-125b | Prognosis of more significant disease severity | |
Distinguishes patients with sepsis from patients without sepsis | ||
miR-125b: increased risk of mortality in patients with sepsis | ||
miR-125a: risk of sepsis and increased mortality | ||
Membrane receptors, cell proteins, and metabolites | ||
CD64 | Prognosis of disease severity | [46] |
28-day mortality predictor | ||
Early diagnosis of infection | ||
CD68 | Prognosis of disease severity | [86] |
Microglial activation | ||
NFL | Indicates risk and severity of sepsis-associated encephalopathy | [87] |
NFH | Indicates risk and severity of sepsis-associated encephalopathy | [87] |
NSE | Diagnosis of sepsis-associated encephalopathy | |
30-day mortality risk | ||
Risk of delirium | ||
Neuronal injury marker in sepsis | ||
Presepsin | Initial diagnosis and sepsis risk stratification | [48] |
Potential marker to distinguish Gram ( +) and Gram (-) bacterial infection | ||
TREM-1 | Sepsis indicator | |
An early distinction between sepsis and SIRS | ||
Predictive of septic shock | ||
Peptide precursor of the hormone and hormone | ||
MR-proADM | Discrimination of survivors and non-survivors | [92] |
Organ dysfunction marker | ||
PCT | Diagnosis of sepsis | |
Predicts Bacterial Infection | ||
NT-proBNP | In the acute phase of sepsis it indicates a risk of long-term impairment of physical function and muscle strength | [55] |
Predict mortality risk | [52] | |
Neutrophil, cells, and related biomarkers | ||
Lactate | Predictive of mortality | [93] |
Risk stratification of patients with suspected infection | ||
MPO | Increase in patients with DIC | |
Indicates organ dysfunction | ||
Mortality predictor at 28 and 90 days | ||
Risk of septic shock | ||
NET generation | ||
Resistin | Sepsis indicator | |
Risk of septic shock | ||
28-day mortality predictor | ||
Soluble receptors | ||
sPD-L1 | Prognosis of disease severity | |
28-day mortality predictor | ||
Indicates immunosuppression | ||
suPAR | Predictive mortality at 7 and 30 days | [66] |
Risk of patients with suspected infection | ||
sTNFR-1 | Prognosis of 28-day mortality | |
Risk of septic shock | ||
Risk of delirium | ||
Lipoproteins | ||
LDL-C | Protective effect against sepsis | [99] |
The decrease can cause a risk of sepsis and admission to the ICU | ||
HDL | Low levels: mortality prognosis and adverse clinical outcomes | |
Predictive for MODS | ||
T-chol | The decrease has a worse prognosis in sepsis | [102] |