Sepsis Biomarkers: Advancements and Clinical Applications-A Narrative Review

Abstract

Sepsis is now defined as a life-threatening syndrome of organ dysfunction triggered by a dysregulated host response to infection, posing significant challenges in critical care. The main objective of this review is to evaluate the potential of emerging biomarkers for early diagnosis and accurate prognosis in sepsis management, which are pivotal for enhancing patient outcomes. Despite advances in supportive care, traditional biomarkers like C-reactive protein and procalcitonin have limitations, and recent studies have identified novel biomarkers with increased sensitivity and specificity, including circular RNAs, HOXA distal transcript antisense RNA, microRNA-486-5p, protein C, triiodothyronine, and prokineticin 2. These emerging biomarkers hold promising potential for the early detection and prognostication of sepsis. They play a crucial role not only in diagnosis but also in guiding antibiotic therapy and evaluating treatment effectiveness. The introduction of point-of-care testing technologies has brought about a paradigm shift in biomarker application, enabling swift and real-time patient evaluation. Despite these advancements, challenges persist, notably concerning biomarker variability and the lack of standardized thresholds. This review summarizes the latest advancements in sepsis biomarker research, spotlighting the progress and clinical implications. It emphasizes the significance of multi-biomarker strategies and the feasibility of personalized medicine in sepsis management. Further verification of biomarkers on a large scale and their integration into clinical practice are advocated to maximize their efficacy in future sepsis treatment.

Keywords: biomarkers; clinical applications; diagnosis; prognosis; sepsis.

Figure 1

Pathophysiological mechanisms and associated biomarkers of sepsis. The biomarkers are categorized based on their diagnostic and prognostic roles, with a distinction made between traditional and novel biomarkers. Some biomarkers are shown to have dual functions, serving both diagnostic and prognostic purposes, reflecting their overlapping roles in sepsis management. The distribution of biomarkers in the figure is designed to represent their relevance of use in clinical practice. The clipart used in this figure has been sourced and adapted from Servier’s Medical Art database (https://smart.servier.com (accessed on 20 June 2024).