The following is a summary of “Synergistic impact of innate immunity hyper-activation and endothelial dysfunction on the magnitude of organ failure in the infection-sepsis continuum,” published in the June 2024 issue of Infectious Disease by Fuente et al.

Early detection of organ failure in infection remains a critical challenge, highlighting the need for novel host response biomarkers.

Researchers conducted a retrospective study identifying host response biomarkers that predict organ failure in infection, enabling earlier intervention and potentially improved patient outcomes.

They profiled 20 biomarkers across innate immunity, T-cell response, endothelial dysfunction, coagulation, and immunosuppression in 2 cohorts. The first cohort included 180 patients with infections of diverse severity (IDS) and 53 patients without infections of diverse severity (nIDS). Biomarkers that best distinguished between patients with IDS and nIDS (based on area under the curve, AUC) were analyzed using linear regression for association with SOFA score. Analysis was repeated in a cohort of 174 patients with IDS to validate the findings.

The result showed that AUCs of 0.75 or greater were demonstrated by the biomarkers C-reactive protein, procalcitonin, pentraxin-3, lipocalin-2, TNF-α, angiopoietin-2, TREM-1, and IL-15 for differentiating IDS from nIDS.The group of biomarkers comprising lipocalin-2, IL-15, TREM-1, and angiopoietin-2, collectively referred to as Dys-4, exhibited the strongest correlation with SOFA scores in IDS. The adjusted regression coefficients, standard errors, and P-values were as follows: Dys-4 (3.55; 0.44; <0.001), lipocalin-2 (2.24; 0.28; <0.001), angiopoietin-2 (1.92; 0.33; <0.001), IL-15 (1.78; 0.40; <0.001), TREM-1 (1.74; 0.46; <0.001), TNF-α (1.60; 0.31; <0.001), pentraxin-3 (1.12; 0.18; <0.001), and procalcitonin (0.85; 0.12; <0.001). Similar results were observed in the validation cohort provided by Dys-4.

Investigators concluded that Dys-4, a marker of combined immune response and endothelial damage, strongly predicts organ failure in sepsis.

Source: ijidonline.com/article/S1201-9712(24)00213-3/