Combination of C‐reactive protein, procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis
Background Although early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis. Methods We enrolled 129 children with infection into three groups: non‐sep...
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| Veröffentlicht in: | Journal of clinical laboratory analysis 2022-07, Vol.36 (7), p.e24505-n/a |
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| description | Background
Although early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis.
Methods
We enrolled 129 children with infection into three groups: non‐sepsis infection (33), Sepsis 1.0 (hyperinflammatory state, 67), and Sepsis 3.0 (organ dysfunction, 29). Another 32 children with no infections were included as controls. Serum C‐reactive protein (CRP), procalcitonin (PCT), interleukin (IL)‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor (TNF)‐α, interferon (IFN)‐α, and IFN‐γ were assessed to diagnose the two stages, and their diagnostic capacities were evaluated using receiver operating characteristic (ROC) curves. We also examined whether combining biomarkers improved diagnostic efficiency.
Results
Significantly higher CRP, PCT, and IL‐6 levels were detected in the Sepsis 1.0 than the non‐sepsis infection group (p |
| doi_str_mv | 10.1002/jcla.24505 |
| format | Article |
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Although early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis.
Methods
We enrolled 129 children with infection into three groups: non‐sepsis infection (33), Sepsis 1.0 (hyperinflammatory state, 67), and Sepsis 3.0 (organ dysfunction, 29). Another 32 children with no infections were included as controls. Serum C‐reactive protein (CRP), procalcitonin (PCT), interleukin (IL)‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor (TNF)‐α, interferon (IFN)‐α, and IFN‐γ were assessed to diagnose the two stages, and their diagnostic capacities were evaluated using receiver operating characteristic (ROC) curves. We also examined whether combining biomarkers improved diagnostic efficiency.
Results
Significantly higher CRP, PCT, and IL‐6 levels were detected in the Sepsis 1.0 than the non‐sepsis infection group (p < 0.001). The areas under the curve (AUCs) for diagnosing Sepsis 1.0 were 0.974 (CRP), 0.913 (PCT) and 0.919 (IL‐6). A combination of any two biomarkers increased diagnostic sensitivity to ≥92.54% and specificity to 100.00%. Significantly higher PCT, IL‐8, and IL‐10 levels were found in the Sepsis 3.0 than the Sepsis 1.0 group (p ≤ 0.01), with AUCs for diagnosing Sepsis 3.0 0.807 (PCT), 0.711 (IL‐8), and 0.860 (IL‐10). Combining these three biomarkers increased diagnostic sensitivity to 96.55% and specificity to 94.03%.
Conclusion
In pediatric sepsis, combining any two of CRP, PCT, and IL‐6 can accurately diagnose the hyperinflammatory state and increase diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of PCT, IL‐8, and IL‐10.
Serum C‐reactive protein, procalcitonin, cytokines (IL‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, TNF‐α, IFN‐α, and IFN‐γ) were assessed to diagnose the stages of hyperinflammatory state and organ dysfunction in pediatric sepsis. We found that C‐reactive protein, procalcitonin, and IL‐6 are early indicators of the hyperinflammatory state. A combination of any two markers increased diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of procalcitonin, IL‐8, and IL‐10.</description><identifier>ISSN: 0887-8013</identifier><identifier>EISSN: 1098-2825</identifier><identifier>DOI: 10.1002/jcla.24505</identifier><identifier>PMID: 35622931</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Biomarkers ; Blood platelets ; Children & youth ; Creatinine ; Cytokines ; C‐reactive protein ; Diagnosis ; hyperinflammatory state ; Infections ; Inflammation ; Interferon ; Interleukin 6 ; organ dysfunction ; pediatric sepsis ; Pediatrics ; Procalcitonin ; Sepsis ; Tumor necrosis factor ; Tumor necrosis factor-TNF</subject><ispartof>Journal of clinical laboratory analysis, 2022-07, Vol.36 (7), p.e24505-n/a</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC.</rights><rights>2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4485-ef3c43d186d6b355c68a6fe0e324fc3815dd4ce785c4cfc279f3a64c4dc2b7df3</citedby><cites>FETCH-LOGICAL-c4485-ef3c43d186d6b355c68a6fe0e324fc3815dd4ce785c4cfc279f3a64c4dc2b7df3</cites><orcidid>0000-0003-0803-657X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279984/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9279984/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1416,11561,27923,27924,45573,45574,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35622931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeng, Gongbo</creatorcontrib><creatorcontrib>Chen, Dong</creatorcontrib><creatorcontrib>Zhou, Renxi</creatorcontrib><creatorcontrib>Zhao, Xinfeng</creatorcontrib><creatorcontrib>Ye, Cuiying</creatorcontrib><creatorcontrib>Tao, Huiting</creatorcontrib><creatorcontrib>Sheng, Wenbin</creatorcontrib><creatorcontrib>Wu, Yidong</creatorcontrib><title>Combination of C‐reactive protein, procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis</title><title>Journal of clinical laboratory analysis</title><addtitle>J Clin Lab Anal</addtitle><description>Background
Although early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis.
Methods
We enrolled 129 children with infection into three groups: non‐sepsis infection (33), Sepsis 1.0 (hyperinflammatory state, 67), and Sepsis 3.0 (organ dysfunction, 29). Another 32 children with no infections were included as controls. Serum C‐reactive protein (CRP), procalcitonin (PCT), interleukin (IL)‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor (TNF)‐α, interferon (IFN)‐α, and IFN‐γ were assessed to diagnose the two stages, and their diagnostic capacities were evaluated using receiver operating characteristic (ROC) curves. We also examined whether combining biomarkers improved diagnostic efficiency.
Results
Significantly higher CRP, PCT, and IL‐6 levels were detected in the Sepsis 1.0 than the non‐sepsis infection group (p < 0.001). The areas under the curve (AUCs) for diagnosing Sepsis 1.0 were 0.974 (CRP), 0.913 (PCT) and 0.919 (IL‐6). A combination of any two biomarkers increased diagnostic sensitivity to ≥92.54% and specificity to 100.00%. Significantly higher PCT, IL‐8, and IL‐10 levels were found in the Sepsis 3.0 than the Sepsis 1.0 group (p ≤ 0.01), with AUCs for diagnosing Sepsis 3.0 0.807 (PCT), 0.711 (IL‐8), and 0.860 (IL‐10). Combining these three biomarkers increased diagnostic sensitivity to 96.55% and specificity to 94.03%.
Conclusion
In pediatric sepsis, combining any two of CRP, PCT, and IL‐6 can accurately diagnose the hyperinflammatory state and increase diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of PCT, IL‐8, and IL‐10.
Serum C‐reactive protein, procalcitonin, cytokines (IL‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, TNF‐α, IFN‐α, and IFN‐γ) were assessed to diagnose the stages of hyperinflammatory state and organ dysfunction in pediatric sepsis. We found that C‐reactive protein, procalcitonin, and IL‐6 are early indicators of the hyperinflammatory state. A combination of any two markers increased diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of procalcitonin, IL‐8, and IL‐10.</description><subject>Biomarkers</subject><subject>Blood platelets</subject><subject>Children & youth</subject><subject>Creatinine</subject><subject>Cytokines</subject><subject>C‐reactive protein</subject><subject>Diagnosis</subject><subject>hyperinflammatory state</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Interferon</subject><subject>Interleukin 6</subject><subject>organ dysfunction</subject><subject>pediatric sepsis</subject><subject>Pediatrics</subject><subject>Procalcitonin</subject><subject>Sepsis</subject><subject>Tumor necrosis factor</subject><subject>Tumor necrosis factor-TNF</subject><issn>0887-8013</issn><issn>1098-2825</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kkuO1DAQQCMEYpqBDQdAltggNBn8ycfZII0iPoNaYgNry22Xe9xK7GAng7LjCByDc3ESnE4zAhZ4U2X51VNZVVn2lOBLgjF9dVCdvKRFict72YbghueU0_J-tsGc1znHhJ1lj2I8YIx5Q6qH2RkrK0obRjbZj9b3O-vkaL1D3qD257fvAaQa7S2gIfgRrLtYEiU7ZUfvluv1NlHVKfILJJ1ec4KR8QGBDN2MtJV756ONi_dmHiBYZzrZ93L0YUZxlCMcS33YS4f0HM3k1LER69AAqX4MVqEIQ5I8zh4Y2UV4corn2ee3bz617_Ptx3fX7dU2V0XByxwMUwXThFe62rGyVBWXlQEMjBZGMU5KrQsFNS9VoYyidWOYrApVaEV3tTbsPHu9eodp14NW4MYgOzEE28swCy-t-PvF2Rux97eiSa6GF0nw4iQI_ssEcRS9jQq6TjrwUxS0qgmteBpGQp__gx78FFz6XqJ4OjXlZaJerpQKPsYA5q4ZgsWyAGJZAHFcgAQ_-7P9O_T3xBNAVuCr7WD-j0p8aLdXq_QXMkfCKA</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Zeng, Gongbo</creator><creator>Chen, Dong</creator><creator>Zhou, Renxi</creator><creator>Zhao, Xinfeng</creator><creator>Ye, Cuiying</creator><creator>Tao, Huiting</creator><creator>Sheng, Wenbin</creator><creator>Wu, Yidong</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0803-657X</orcidid></search><sort><creationdate>202207</creationdate><title>Combination of C‐reactive protein, procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis</title><author>Zeng, Gongbo ; Chen, Dong ; Zhou, Renxi ; Zhao, Xinfeng ; Ye, Cuiying ; Tao, Huiting ; Sheng, Wenbin ; Wu, Yidong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4485-ef3c43d186d6b355c68a6fe0e324fc3815dd4ce785c4cfc279f3a64c4dc2b7df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biomarkers</topic><topic>Blood platelets</topic><topic>Children & youth</topic><topic>Creatinine</topic><topic>Cytokines</topic><topic>C‐reactive protein</topic><topic>Diagnosis</topic><topic>hyperinflammatory state</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Interferon</topic><topic>Interleukin 6</topic><topic>organ dysfunction</topic><topic>pediatric sepsis</topic><topic>Pediatrics</topic><topic>Procalcitonin</topic><topic>Sepsis</topic><topic>Tumor necrosis factor</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeng, Gongbo</creatorcontrib><creatorcontrib>Chen, Dong</creatorcontrib><creatorcontrib>Zhou, Renxi</creatorcontrib><creatorcontrib>Zhao, Xinfeng</creatorcontrib><creatorcontrib>Ye, Cuiying</creatorcontrib><creatorcontrib>Tao, Huiting</creatorcontrib><creatorcontrib>Sheng, Wenbin</creatorcontrib><creatorcontrib>Wu, Yidong</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical laboratory analysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeng, Gongbo</au><au>Chen, Dong</au><au>Zhou, Renxi</au><au>Zhao, Xinfeng</au><au>Ye, Cuiying</au><au>Tao, Huiting</au><au>Sheng, Wenbin</au><au>Wu, Yidong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combination of C‐reactive protein, procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis</atitle><jtitle>Journal of clinical laboratory analysis</jtitle><addtitle>J Clin Lab Anal</addtitle><date>2022-07</date><risdate>2022</risdate><volume>36</volume><issue>7</issue><spage>e24505</spage><epage>n/a</epage><pages>e24505-n/a</pages><issn>0887-8013</issn><eissn>1098-2825</eissn><abstract>Background
Although early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis.
Methods
We enrolled 129 children with infection into three groups: non‐sepsis infection (33), Sepsis 1.0 (hyperinflammatory state, 67), and Sepsis 3.0 (organ dysfunction, 29). Another 32 children with no infections were included as controls. Serum C‐reactive protein (CRP), procalcitonin (PCT), interleukin (IL)‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor (TNF)‐α, interferon (IFN)‐α, and IFN‐γ were assessed to diagnose the two stages, and their diagnostic capacities were evaluated using receiver operating characteristic (ROC) curves. We also examined whether combining biomarkers improved diagnostic efficiency.
Results
Significantly higher CRP, PCT, and IL‐6 levels were detected in the Sepsis 1.0 than the non‐sepsis infection group (p < 0.001). The areas under the curve (AUCs) for diagnosing Sepsis 1.0 were 0.974 (CRP), 0.913 (PCT) and 0.919 (IL‐6). A combination of any two biomarkers increased diagnostic sensitivity to ≥92.54% and specificity to 100.00%. Significantly higher PCT, IL‐8, and IL‐10 levels were found in the Sepsis 3.0 than the Sepsis 1.0 group (p ≤ 0.01), with AUCs for diagnosing Sepsis 3.0 0.807 (PCT), 0.711 (IL‐8), and 0.860 (IL‐10). Combining these three biomarkers increased diagnostic sensitivity to 96.55% and specificity to 94.03%.
Conclusion
In pediatric sepsis, combining any two of CRP, PCT, and IL‐6 can accurately diagnose the hyperinflammatory state and increase diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of PCT, IL‐8, and IL‐10.
Serum C‐reactive protein, procalcitonin, cytokines (IL‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, TNF‐α, IFN‐α, and IFN‐γ) were assessed to diagnose the stages of hyperinflammatory state and organ dysfunction in pediatric sepsis. We found that C‐reactive protein, procalcitonin, and IL‐6 are early indicators of the hyperinflammatory state. A combination of any two markers increased diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of procalcitonin, IL‐8, and IL‐10.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>35622931</pmid><doi>10.1002/jcla.24505</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0803-657X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Wiley-Blackwell Open Access Titles; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals; PubMed Central |
| subjects | Biomarkers Blood platelets Children & youth Creatinine Cytokines C‐reactive protein Diagnosis hyperinflammatory state Infections Inflammation Interferon Interleukin 6 organ dysfunction pediatric sepsis Pediatrics Procalcitonin Sepsis Tumor necrosis factor Tumor necrosis factor-TNF |
| title | Combination of C‐reactive protein, procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis |
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