Pedro Martínez-Paz1, Marta Aragón-Camino2, Esther Gómez-Sánchez3, Mario Lorenzo-López3, Estefanía Gómez-Pesquera3, Alejandra Fadrique-Fuentes4, Pilar Liu2, Álvaro Tamayo-Velasco5, Christian Ortega-Loubon6, Marta Martín-Fernández7, Hugo Gonzalo-Benito8, Emilio García-Morán9, María Heredia-Rodríguez10, Eduardo Tamayo3. 1. Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain. 2. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain. 3. Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Anesthesiology and Resuscitation Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain. 4. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Anesthesiology and Resuscitation Service, Hospital of Medina del Campo. 24 Peñaranda St, 47400 Medina del Campo (Valladolid), Spain. 5. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Hematology and Hemotherapy Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain. 6. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Cardiovascular Surgery Service, Hospital Clinic of Barcelona. 170 Villarroel St, 08036 Barcelona, Spain. 7. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain. 8. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Institute of Health Sciences of Castile and Leon (IECSCYL). Santa Clara Sq, 42002 Soria, Spain. Electronic address: hgonzalob@saludcastillayleon.es. 9. BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Cardiology Service, University Clinical Hospital of Valladolid. 3 Ramón y Cajal Ave, 47003 Valladolid, Spain. 10. Department of Surgery, Faculty of Medicine, University of Valladolid. 7 Ramón y Cajal Ave, 47005 Valladolid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine. Valladolid, Spain; Anesthesiology and Resuscitation Service, University Hospital of Salamanca. 182 San Vicente Rd, 37007 Salamanca, Spain.
Abstract
OBJECTIVES: To obtain a gene expression signature to distinguish between septic shock and non-septic shock in postoperative patients, since patients with both conditions show similar signs and symptoms. METHODS: Differentially expressed genes were selected by microarray analysis in the discovery cohort. These genes were evaluated by quantitative real time polymerase chain reactions in the validation cohort to determine their reliability and predictive capacity by receiver operating characteristic curve analysis. RESULTS: Differentially expressed genes selected were IGHG1, IL1R2, LCN2, LTF, MMP8, and OLFM4. The multivariate regression model for gene expression presented an area under the curve value of 0.922. These genes were able to discern between both shock conditions better than other biomarkers used for diagnosis of these conditions, such as procalcitonin (0.589), C-reactive protein (0.705), or neutrophils (0.605). CONCLUSIONS: Gene expression patterns provided a robust tool to distinguish septic shock from non-septic shock postsurgical patients and shows the potential to provide an immediate and specific treatment, avoiding the unnecessary use of broad-spectrum antibiotics and the development of antimicrobial resistance, secondary infections and increase health care costs.
OBJECTIVES: To obtain a gene expression signature to distinguish between septic shock and non-septic shock in postoperative patients, since patients with both conditions show similar signs and symptoms. METHODS: Differentially expressed genes were selected by microarray analysis in the discovery cohort. These genes were evaluated by quantitative real time polymerase chain reactions in the validation cohort to determine their reliability and predictive capacity by receiver operating characteristic curve analysis. RESULTS: Differentially expressed genes selected were IGHG1, IL1R2, LCN2, LTF, MMP8, and OLFM4. The multivariate regression model for gene expression presented an area under the curve value of 0.922. These genes were able to discern between both shock conditions better than other biomarkers used for diagnosis of these conditions, such as procalcitonin (0.589), C-reactive protein (0.705), or neutrophils (0.605). CONCLUSIONS: Gene expression patterns provided a robust tool to distinguish septic shock from non-septic shock postsurgical patients and shows the potential to provide an immediate and specific treatment, avoiding the unnecessary use of broad-spectrum antibiotics and the development of antimicrobial resistance, secondary infections and increase health care costs.
Authors: Sonia Y Velásquez; Anna Coulibaly; Carsten Sticht; Jutta Schulte; Bianka Hahn; Timo Sturm; Roman Schefzik; Manfred Thiel; Holger A Lindner Journal: Front Immunol Date: 2022-06-30 Impact factor: 8.786