Abstract
Sepsis is one of the leading causes of death worldwide with high mortality rates and a pathological complexity hindering early and accurate diagnosis. Today, laboratory culture tests are the epitome of pathogen recognition in sepsis. However, their consistency remains an issue of controversy with false negative results often observed. Clinically used blood markers, C reactive protein (CRP) and procalcitonin (PCT) are indicators of an acute-phase response and thus lack specificity, offering limited diagnostic efficacy. In addition to poor diagnosis, inefficient drug delivery and the increasing prevalence of antibiotic-resistant microorganisms constitute significant barriers in antibiotic stewardship and impede effective therapy. These challenges have prompted the exploration for alternative strategies that pursue accurate diagnosis and effective treatment. Nanomaterials are examined for both diagnostic and therapeutic purposes in sepsis. The nanoparticle (NP)-enabled capture of sepsis causative agents and/or sepsis biomarkers in biofluids can revolutionize sepsis diagnosis. From the therapeutic point of view, currently existing nanoscale drug delivery systems have proven to be excellent allies in targeted therapy, while many other nanotherapeutic applications are envisioned. Herein, the most relevant applications of nanomedicine for the diagnosis, prognosis, and treatment of sepsis is reviewed, providing a critical assessment of their potentiality for clinical translation.
Highlights
Sepsis is one of the leading causes of death worldwide with high mortality is among the leading causes of morbidity and mortality worldwide in intensive care rates and a pathological complexity hindering early and accurate diagnosis
Most of them are primarily used as contrast agents and biosensors to facilitate the detection of either proteins and nucleic acids associated with sepsis (CRP, PCT, and miRNA), pathogenic DNA or bacterial cells by amplifying signals
This study provided with useful insight on carbon nanotubes (CNTs) effectiveness to generate ultrasensitive signals and simultaneously detect and eliminate single bacteria
Summary
Sensitive and specific detection of the infectious pathogen is crucial for the clinical progression and outcome of a septic patient. Current molecular techniques employed for microbial infection diagnosis, including enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) are thought to offer high sensitivity and reproducibility. They require experienced personnel, pose a high risk of sample contamination and lack versatility needed in medical diagnosis.[19]. Nanotechnology can aid in the development of fast, sensitive, and accurate methods for sepsis detection.[20,21] Several NPs have been investigated to allow the diagnosis of sepsis-related microbial infections, such as magnetic (MNPs), gold (AuNPs), fluorescent (silica and quantum dots QDs), and lipid-based NPs.[22,23,24,25,26] Most of them are primarily used as contrast agents and biosensors to facilitate the detection of either proteins and nucleic acids associated with sepsis (CRP, PCT, and miRNA), pathogenic DNA or bacterial cells by amplifying signals. Lens-free interferometric microscopy (LIM) Fluorescence resonance energy transfer (FRET) Magnetic resonance imaging (MRI) Surface-enhanced Raman scattering (SERS)
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