A biomarker panel to discriminate between systemic inflammatory response syndrome and sepsis and sepsis severity

In this study, we report on initial efforts to discover putative biomarkers for differential diagnosis of a systemic inflammatory response syndrome (SIRS) versus sepsis; and different stages of sepsis. In addition, we also investigated whether there are proteins that can discriminate between patients who survived sepsis from those who did not. Our study group consisted of 16 patients, of which 6 died and 10 survived. We daily measured 28 plasma proteins, for the whole stay of the patients in the ICU. We observed that metalloproteinases and sE-selectin play a role in the distinction between SIRS and sepsis, and that IL-1alpha, IP-10, sTNF-R2 and sFas appear to be indicative for the progression from sepsis to septic shock. A combined measurement of MMP-3, -10, IL-1alpha, IP-10, sIL-2R, sFas, sTNF-R1, sRAGE, GM-CSF, IL-1beta and Eotaxin allows for a good separation of patients that survived from those that died (mortality prediction with a sensitivity of 79% and specificity of 86%). Correlation analysis suggests a novel interaction between IL-1alpha and IP-10. The marker panel is ready to be verified in a validation study with or without therapeutic intervention.