Interleukin-37 as a biomarker of mortality risk in patients with sepsis - 18/03/21
, Jin Ma b, c, 1 , Hao Yang d , JianBo Zhang c , ChangRui Sun e , Yu Lei f , MingZong Liu g , Ju Cao a, ⁎ Highlight |
• | Sepsis is a serious syndrome that interferes with patient homeostasis and has a high mortality rate. To our knowledge, this is the first document of using IL-37 to predict mortality risk in patients with sepsis. |
• | We confirmed that the value of serum IL-37 on admission to predict the 28-day mortality of patients with sepsis was second only to the SOFA score, but higher than the commonly used clinical inflammation markers PCT and Hs-CRP, similar to IL-6. |
• | 3 The risk of mortality in patients with sepsis and high serum IL-37 concentration (≥107.05pg/ml) was 4.6 times that of patients with sepsis and low serum concentration. |
Summary |
Background |
Sepsis is a serious syndrome that is caused by an unbalanced inflammatory response to infection and can cause high mortality. The role of interleukin-37 (IL-37) in estimating the mortality in patients with sepsis remains unknown. This study aims to reveal the clinical application of IL-37 as a potentially novel biomarker to predict mortality risk in patients with sepsis.
Methods |
The serum IL-37 level in 114 adult septic patient serum samples on the day of intensive care unit (ICU) admission, 56 non-sepsis ICU patients, and 56 healthy volunteers were measured and analyzed, and the 28-day survival status and sequential organ failure assessment (SOFA) scores of the participants were compared. Furthermore, the area under the receiver operating characteristic curve (AUC) of IL-37, IL-6, and SOFA at ICU admission for 28-day survival was used to evaluate the ability of IL-37 in predicting the mortality of sepsis.
Results |
The serum IL-37 level at admission was elevated in patients with sepsis. Moreover, the concentration of IL-37 in patients with sepsis was significantly higher than that in non-sepsis ICU patients and the healthy control group. In addition, the concentration of serum IL-37 in non-surviving patients with sepsis was significantly higher than that in survivors. In patients with sepsis on the day of ICU admission, the AUC associated with 28-day mortality was 0.67 (p = 0.0022;95% confidence interval [95% CI], 0.57–0.77) for IL-37, 0.75 (p < 0.0001; 95% CI, 0.66–0.84) for SOFA, and 0.62 (p = 0.0342; 95% CI, 0.51–0.72) for IL-6. IL-37 and SOFA scores on the day of ICU admission of the patients with sepsis were found to be independent predictors of 28-day mortality, whereas IL-6 was not. The risk of mortality in patients with sepsis and high serum IL-37 concentration (≥107.05pg/ml) was 4.6 times that of patients with sepsis and low serum concentration. The AUC of IL-37 combined with SOFA-estimated 28-day mortality in patients with sepsis increased from 0.67 (p = 0.0022; 95% CI, 0.57–0.77) to 0.80 (p < 0.0001; 95% CI, 0.711–0.879). In addition, patients with sepsis and high serum IL-37 concentrations (≥107.05pg/ml) had poorer survival rate than those with low serum concentrations (<107.05pg/ml).
Conclusion |
IL-37 concentrations at ICU admission are valuable for predicting the 28-day mortality risk of patients with sepsis, suggesting that IL-37 may be a novel biomarker. These findings can be used as a basis for guiding early clinical decision-making in treating patients with sepsis.
Le texte complet de cet article est disponible en PDF.Keywords : Sepsis, Mortality, Biomarker, IL-37, SOFA score, Interleukin-6 (IL-6), Procalcitonin (PCT)
Abbreviations : IL-37, ICU, SOFA score, AUC, ROC, IL-6, PCT, Hs-CRP, IL, ELISA, 95% CI, SE(%), PPV, OR, APACHE score, WBC, NEU%
Plan
Vol 82 - N° 3
P. 346-354 - mars 2021 Retour au numéro
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