The diagnostic utility of IL-10, IL-17, and PCT in patients with sepsis infection

Abstract

Objective: The purpose of this study is to determine the diagnostic value and net clinical benefit of interleukin-10 (IL-10), interleukin-17 (IL-17), procalcitonin (PCT), and combination tests in patients with sepsis, which will serve as a standard for sepsis early detection.

Patients and methods: An investigation of 84 sepsis patients and 81 patients with local inflammatory diseases admitted to the ICU of Tongji University Hospital in 2021. In addition to comparing inter-group variability, indicators relevant to sepsis diagnosis and therapy were screened.

Results: LASSO regression was used to examine PCT, WBC, CRP, IL-10, IFN-, IL-12, and IL-17. Multivariate logistic regression linked IL-10, IL-17, and PCT to sepsis risk. The AUC values of IL-10, IL-17, PCT, and the combination of the three tests were much higher than those of standard laboratory infection indicators. The combined AUC was greater than the sum of IL-10, IL-17, and PCT (P < 0.05). A clinical decision curve analysis of IL-10, IL-17, PCT, and the three combined tests found that the three combined tests outperformed the individual tests in terms of total clinical benefit rate. To predict the risk of sepsis using IL-10, IL-17, and PCT had an AUC of 0.951, and the model's predicted probability was well matched. An examination of the nomogram model's clinical value demonstrated a considerable net therapeutic benefit between 3 and 87%.

Conclusion: The IL-10, IL-17, and PCT tests all have a high diagnostic value for patients with sepsis, and the combination of the three tests outperforms the individual tests in terms of diagnostic performance, while the combined tests have a higher overall clinical benefit rate.

Keywords: IL-10; IL-17; PCT; diagnostic value; nomogram; sepsis.

Figure 1

Screening of independent variables based on LASSO regression. (A) The optimal value of parameter λ is screened in the LASSO model using the minimum criterion for 10-fold cross-validation [the two dashed lines in the figure indicate the λ and 1-se values of the minimized mean square error (MSE)]. (B) LASSO regression screening variables profile (Lambda optimal take when screening retention variables).

Figure 2

Multifactorial logistic regression analysis of the risk of sepsis development forest plot.

Figure 3

Correlation of IL-10 with WBC, CRP, IL-6, IL-8, IL-12, and SOFA scores in patients in the infection and sepsis groups. (A) Correlation of IL-10 with WBC in patients in the sepsis groups; (B) Correlation of IL-10 with CRP in patients in the sepsis groups; (C) Correlation of IL-10 with IL-6 in patients in the sepsis groups; (D) Correlation of IL-10 with IL-8 in patients in the sepsis groups; (E) Correlation of IL-10 with IL-12 in patients in the sepsis groups; (F) Correlation of IL-10 with SOFA scores in patients in the sepsis groups; (G) Correlation of IL-10 with WBC in patients in the infection groups; (H) Correlation of IL-10 with CRP in patients in the infection groups; (I) Correlation of IL-10 with IL-6 in patients in the infection groups; (J) Correlation of IL-10 with IL-8 in patients in the infection groups; (K) Correlation of IL-10 with IL-12 in patients in the infection groups; (L) Correlation of IL-10 with SOFA scores in patients in the infection groups.

Figure 4

Correlation of IL-12 with WBC, CRP, IL-6, IL-8, IL-12, and SOFA scores in patients in the infection and sepsis groups. (A) Correlation of IL-12 with WBC in patients in the sepsis groups; (B) Correlation of IL-12 with CRP in patients in the sepsis groups; (C) Correlation of IL-12 with IL-6 in patients in the sepsis groups; (D) Correlation of IL-12 with IL-8 in patients in the sepsis groups; (E) Correlation of IL-12 with IL-12 in patients in the sepsis groups; (F) Correlation of IL-12 with SOFA scores in patients in the sepsis groups; (G) Correlation of IL-12 with WBC in patients in the infection groups; (H) Correlation of IL-12 with CRP in patients in the infection groups; (I) Correlation of IL-12 with IL-6 in patients in the infection groups; (J) Correlation of IL-12 with IL-8 in patients in the infection groups; (K) Correlation of IL-12 with IL-12 in patients in the infection groups; (L) Correlation of IL-12 with SOFA scores in patients in the infection groups.

Figure 5

Correlation of PCT with WBC, CRP, IL-6, IL-8, IL-12, and SOFA scores in patients in the infection and sepsis groups. (A) Correlation of PCT with WBC in patients in the sepsis groups; (B) Correlation of PCT with CRP in patients in the sepsis groups; (C) Correlation of PCT with IL-6 in patients in the sepsis groups; (D) Correlation of PCT with IL-8 in patients in the sepsis groups; (E) Correlation of PCT with IL-12 in patients in the sepsis groups; (F) Correlation of PCT with SOFA scores in patients in the sepsis groups; (G) Correlation of PCT with WBC in patients in the infection groups; (H) Correlation of PCT with CRP in patients in the infection groups; (I) Correlation of PCT with IL-6 in patients in the infection groups; (J) Correlation of PCT with IL-8 in patients in the infection groups; (K) Correlation of PCT with IL-12 in patients in the infection groups; (L) Correlation of PCT with SOFA scores in patients in the infection groups.

Figure 6

The diagnostic performance of LASSO regression analysis variables in patients with sepsis vs. infection. (A) The diagnostic performance of WBC in patients in the sepsis and infection group; (B) The diagnostic performance of CRP in patients in the sepsis and infection group; (C) The diagnostic performance of IFN-γ in patients in the sepsis and infection group; (D) The diagnostic performance of IL-12 in patients in the sepsis and infection group; (E) The diagnostic performance of SOFA in patients in the sepsis and infection group; (F) The diagnostic performance of IL-10 in patients in the sepsis and infection group; (G) The diagnostic performance of IL-17 in patients in the sepsis and infection group; (H) The diagnostic performance of PCT in patients in the sepsis and infection group; (I) The diagnostic performance of IL-10+IL-17+PCT in patients in the sepsis and infection group.

Figure 7

Clinical decision-making curves for the development of sepsis in infected individuals were analyzed (X: probability with value, Y: net benefit, Black line: hypothesis of no sepsis in all patients, Gray line: hypothesis of sepsis in all patients).

Figure 8

The nomogram predicting the risk of sepsis in infected patients.

Figure 9

The validation of a predictive model for the risk of sepsis in infected patients. (A) ROC curve of the prediction model for the risk of sepsis in infected patients; (B) Calibration curve of the model for the risk of sepsis in infected patients.

Figure 10

Clinical decision curve for the risk of sepsis in infected patients. (X: probability with value, Y: net benefit, black line: hypothesis of no sepsis in all patients, gray line: hypothesis of sepsis in all patients).