A Three-Protein Panel to Support the Diagnosis of Sepsis in Children.

Francisco J Pilar-Orive,Susana Garcia-Obregon,Felix Elortza,Itziar Astigarraga,Mikel Azkargorta

doi:10.3390/jcm11061563

Abstract

Sepsis is a syndrome without a standard validated diagnostic test. Early recognition is crucial. Serum proteome analysis in children with sepsis may identify new biomarkers. This study aimed to find suitable blood biomarkers for an early diagnosis of sepsis. An analytical observational case-control study was carried out in a single center. Children admitted to a Pediatric Intensive Care Unit with clinical diagnosed sepsis were eligible for study. A proteomic analysis conducted by mass spectrometry was performed. Forty patients with sepsis and 24 healthy donors were recruited. Proteomics results revealed 44 proteins differentially expressed between patients and healthy controls. Six proteins were selected to be validated: lactoferrin, serum amyloid-A1 (SAA-1), complement factor B, leucine-rich alpha-2 glycoprotein (LRG1), soluble interleukin-2 alpha chain receptor (sCD25) and soluble haptoglobin–hemoglobin receptor. Our results showed that sCD25, SAA-1, and LRG1 had high levels of specificity and sensitivity, as well as an excellent area under the ROC curve (>0.9). Our study provides a serum proteomic analysis that identifies new diagnostic biomarkers in sepsis. SAA-1, sCD25 and LRG1 were able to separate septic from healthy donor, so they could be used together with other clinical and analytical features to improve sepsis diagnosis in children.

Highlights

The objective of this study is the identification of new serum biomarkers for the diagnosis of sepsis in children that will allow recognition for the early identification and treatment of the disease
The prevalence of sepsis in the Pediatric Intensive Care Unit (PICU) population was 3%, with septic shock accounting for 82.5% of the patients with sepsis
Laboratory analysis for C-reactive protein (CRP), Procalcitonin (PCT) and lactate were carried out as part of the routine studies performed in patients with suspected severe infection

Summary

Introduction

Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; Pediatric Service, Hospital Universitario Cruces, 48903 Barakaldo, Spain. Proteomics Platform, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160 Derio, Spain; Physiology Department, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain. Serum proteome analysis in children with sepsis may identify new biomarkers. This study aimed to find suitable blood biomarkers for an early diagnosis of sepsis. Care Unit with clinical diagnosed sepsis were eligible for study. A proteomic analysis conducted by mass spectrometry was performed. B, leucine-rich alpha-2 glycoprotein (LRG1), soluble interleukin-2 alpha chain receptor (sCD25) and soluble haptoglobin–hemoglobin receptor. Our results showed that sCD25, SAA-1, and LRG1 had high levels of specificity and sensitivity, as well as an excellent area under the ROC curve (>0.9)

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Conclusion