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The following is a summary of “Study on the diagnostic role of exosome-derived miRNAs in postoperative septic shock and non-septic shock patients,” published in the March 2025 issue of Critical Care by García-Concejo et al. 

The difficulty in rapidly differentiating septic from non-septic shock, despite its critical importance, necessitates the exploration of novel biomarkers like extracellular vesicle (EV)-derived MicroRNA (miRNAs).  

Researchers conducted a retrospective study to identify EV-derived miRNA signatures that distinguished septic shock from non-septic shock in individuals after surgery, aiming to enhance diagnostic accuracy and clinical decision-making.  

They analyzed miRNA profiles in individuals with shock across 2 Spanish hospitals, 2 cohorts were recruited from Intensive Care Units: a discovery cohort (109 individuals) and a validation cohort (52 individuals). Plasma samples were collected within 24 hours of shock diagnosis and analyzed through miRNA sequencing. High-throughput sequencing in the discovery cohort identified differentially expressed miRNAs, which were validated using qPCR. 

The results showed that 30 miRNAs were significantly differentially expressed (SDE) between individuals with sepsis and non-sepsis shock. Among these, 6 miRNAs—miR-100-5p, miR-484, miR-10a-5p, miR-148a-3p, miR-342-3p, and miR-451a—exhibited strong diagnostic potential for septic shock. A combination of miR-100-5p, miR-148a-3p, and miR-451a achieved an area under the curve (AUC) of 0.894, while qPCR validation in the validation cohort yielded an AUC of 0.960.  

Investigators concluded that a 3-miRNA signature derived from EV effectively distinguished patients with sepsis from non-septic shock in post-surgery. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05320-y