Commentary: Plasma Metabolic Profiling of Pediatric Sepsis in a Chinese Cohort.

Abstract

Sepsis is a complicated and heterogeneous clinical syndrome with the overall incidence of 48 cases per 100,000 person-years (Fleischmann-Struzek et al., 2018), which is characterized by maladaptive immune and metabolic responses with ensuing organ dysfunction (Weis et al., 2017; Fitzpatrick, 2019). A hypermetabolic state occurs at the onset of sepsis, including highly amplified protein synthesis, tachypnea, tachycardia, and stress hyperglycemia (Pravda, 2014; Plummer and Deane, 2016). In 2016, Sepsis-3 in adult was defined as life-threatening organ dysfunction caused by a dysregulated host response to infection (Shankar-Hari et al., 2016). Metabolic disorders are critical for sepsis-associated organ dysfunction, which is increasingly attracting more attention (Cecconi et al., 2018). In 2020, the Surviving Sepsis Campaign guidelines for sepsis shock and sepsis-associated organ dysfunction in children refer to endocrine and metabolic therapies to maintain optimal glucose and blood calcium levels (Weiss et al., 2020). From another prospective, immunometabolism exerts its regulatory role on sepsis, and targeting the immunometabolism during sepsis offers great potential for development of novel therapeutics (Kumar, 2018, 2019; Koutroulis et al., 2019). Serum and plasma metabolites include nucleotides, nucleosides, amino acids, glucose moieties, and more. Metabolome profiling provides a new and comprehensive perspective on a host's metabolism, which makes it a possible way to diagnose a patient or develop novel biomarkers (Wilmanski et al., 2019; Bar et al., 2020). Clinical metabolomics has been recognized as a promising tool for prediction of sepsis mortality (Wang et al., 2020). However, study on pediatric sepsis metabolic profiles is limited. Recently, Li et al. (2021) reported the serum metabolome profiling of pediatric sepsis.