A Transcriptomic Biomarker to Quantify Systemic Inflammation in Sepsis - A Prospective Multicenter Phase II Diagnostic Study.

Abstract : Development of a dysregulated immune response discriminates sepsis from uncomplicated infection. Currently used biomarkers fail to describe simultaneously occurring pro- and anti-inflammatory responses potentially amenable to therapy. Marker candidates were screened by microarray and, after transfer to a platform allowing point-of-care testing, validated in a confirmation set of 246 medical and surgical patients. We identified up-regulated pathways reflecting innate effector mechanisms, while down-regulated pathways related to adaptive lymphocyte functions. A panel of markers composed of three up- (Toll-like receptor 5; Protectin; Clusterin) and 4 down-regulated transcripts (Fibrinogen-like 2; Interleukin-7 receptor; Major histocompatibility complex class II, DP alpha1; Carboxypeptidase, vitellogenic-like) described the magnitude of immune alterations. The created gene expression score was significantly greater in patients with definite as well as with possible/probable infection than with no infection (median (Q25/Q75): 80 (60/101)) and 81 (58/97 vs. 49 (27/66), AUC-ROC=0.812 (95%-CI 0.755-0.869), p<0.0001). Down-regulated lymphocyte markers were associated with prognosis with good sensitivity but limited specificity. Quantifying systemic inflammation by assessment of both pro- and anti-inflammatory innate and adaptive immune responses provides a novel option to identify patients-at-risk and may facilitate immune interventions in sepsis.
Type de document :
Article dans une revue
EBioMedicine, Elsevier, 2016, 6, pp.114-25. 〈10.1016/j.ebiom.2016.03.006〉
Liste complète des métadonnées

Littérature citée [35 références]  Voir  Masquer  Télécharger

Contributeur : Bénédicte Benedic <>
Soumis le : jeudi 26 janvier 2017 - 15:14:31
Dernière modification le : mardi 27 février 2018 - 09:42:35
Document(s) archivé(s) le : jeudi 27 avril 2017 - 14:52:04


Publication financée par une institution


Distributed under a Creative Commons Paternité - Pas d'utilisation commerciale - Pas de modification 4.0 International License




Michael Bauer, Eva Giamarellos-Bourboulis, Andreas Kortgen, Eva Möller, Konrad Felsmann, et al.. A Transcriptomic Biomarker to Quantify Systemic Inflammation in Sepsis - A Prospective Multicenter Phase II Diagnostic Study.. EBioMedicine, Elsevier, 2016, 6, pp.114-25. 〈10.1016/j.ebiom.2016.03.006〉. 〈pasteur-01447024〉



Consultations de la notice


Téléchargements de fichiers