A Correlation between Sequential Organ Failure Assessment Scores and Biomarkers of Inflammation and Infection in Patients with Sepsis.

Abstract

Background: Sepsis has a high mortality rate. While early diagnosis is crucial, there are no effective inflammatory or infectious markers for the diagnosis and prediction of sepsis.

Objective: The present study aimed to establish a correlation between inflammatory and infectious markers and the severity of sepsis at a genetic and cross-sectional level.

Methods: Using transcriptomic and clinical data from the GEO and Dryad databases, we analyzed the expression of eight indicators of inflammatory infection, as well as their diagnostic efficacy. Additionally, we investigated the correlation between eight plasma biomarkers and the Sequential Organ Failure Assessment (SOFA) score in sepsis.

Results: Angiotensin II (Ang-2), fractalkine, interleukin-1 receptor antagonist (IL-1ra), pentraxin 3 (PTX-3), and tumor necrosis factor (TNF)-α type 1 receptor (TNFR1) were up-regulated in sepsis and septic shock. Ang-2, IL-1ra, and PTX-3 had high diagnostic efficacy in both sepsis and septic shock. They also recruited chemokines to generate inflammatory storms, thereby exacerbating the progression of sepsis. Finally, we examined 153 adult non-trauma patients enrolled in the University of Pittsburgh Acute Lung Injury Registry (SOFA score > 2). Ang-2, suppressor of tumorigenicity 2 (ST-2), fractalkine, IL-1ra, TNFR1, procalcitonin (PCT), and PTX-3, but not C-peptide were significantly more expressed in the plasma of the severe sepsis group than in the mild sepsis group. Significant nonlinear correlations were detected between Ang-2, ST-2, IL-1ra, TNFR1, PCT, and PTX-3 levels and SOFA scores.

Conclusion: Our analysis revealed that Ang-2, IL-1ra, and PTX-3 correlated strongly with septic shock at the gene and protein levels, exhibiting nonlinear associations up to a certain point. These findings will facilitate the diagnosis and prognosis of septic shock.