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Updated: Mar 20, 2026
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
A Transcriptomic Biomarker to Quantify Systemic Inflammation in Sepsis - A Prospective Multicenter Phase II
Michael Bauer1, Evangelos J Giamarellos-Bourboulis2, Andreas Kortgen1
1Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Erlanger Allee 101, 07646 Jena, Germany; Center for Sepsis Control & Care, Jena University Hospital, Erlanger Allee 101, 07646 Jena, Germany.
A novel gene expression score, assessing both pro- and anti-inflammatory immune responses, effectively distinguishes sepsis from infection. This tool identifies immune alterations, aiding in sepsis risk stratification and potential therapeutic interventions.
Area of Science:
- Immunology
- Molecular Biology
- Critical Care Medicine
Background:
- Sepsis is characterized by a dysregulated immune response, differentiating it from uncomplicated infections.
- Current biomarkers lack the ability to simultaneously capture both pro- and anti-inflammatory responses crucial for therapeutic targeting.
Purpose of the Study:
- To develop and validate a novel gene expression score for quantifying systemic inflammation in sepsis.
- To identify specific immune response pathways (innate and adaptive) that discriminate sepsis from infection.
Main Methods:
- Microarray screening of marker candidates followed by validation on a point-of-care testing platform.
- Analysis of 246 medical and surgical patients to assess immune alterations.
- Development of a gene expression score using up-regulated (Toll-like receptor 5, Protectin, Clusterin) and down-regulated (Fibrinogen-like 2, Interleukin-7 receptor, MHC class II DP alpha1, Carboxypeptidase vitellogenic-like) transcripts.
Main Results:
- Identified up-regulated innate immune pathways and down-regulated adaptive lymphocyte functions in sepsis.
- The gene expression score was significantly higher in patients with infection (definite or possible/probable) compared to those without infection (AUC-ROC=0.812, p<0.0001).
- Down-regulated lymphocyte markers showed prognostic value with good sensitivity but limited specificity.
Conclusions:
- A comprehensive assessment of both pro- and anti-inflammatory innate and adaptive immune responses offers a novel approach to sepsis identification.
- This gene expression score can identify at-risk patients and may facilitate targeted immune interventions in sepsis.
