MicroRNAs as Potential Diagnostic New Biomarkers in Diagnosis of Sepsis in Pediatric Patients

Background: Sepsis is one of the most common causes of multiorgan failure. Sepsis requires the presence of infection with a resultant systemic inflammatory state. Organ dysfunction occurs from the combination of the two processes. Sepsis is the main cause of mortality at intensive care units, with ۳۰-۵۰% mortality rate for all septic episodes. MicroRNA (miRNA) profile data could be beneficial as a specific diagnostic biomarker for sepsis and systemic inflammatory response syndrome (SIRS). Methods: Expression of miRNAs -۱۲۲, -۱۸۱b, -۲۲۳ and -۱۴۶a levels were assayed by quantitative real time polymerase chain reaction (qRT-PCR) in a prospective case control study, where forty septic cases were compared to ۴۰ healthy controls of matched age and gender.  Results: miRNAs -۱۲۲ and -۱۸۱b were significantly upregulated during early septic conditions, indicating that they could be sensitive and specific biomarkers for diagnosing sepsis. miRNA-۲۲۳ and miRNA-۱۴۶a could also represent highly specific and sensitive diagnostic biomarkers, as they were found to be significantly down-regulated. Serum levels of miRNA-۲۲۳ could be used to predict poor prognosis with ۷۰% sensitivity and ۷۵% specificity, whereas the other three miRNAs could not predict prognosis. Conclusions: Our study shows that all tested miRNAs can be used for early detection of sepsis, with miRNA-۲۲۳ being predictive of mortality, hence preventing multi-organ failure and reducing mortality, and predicting poor outcomes, thereby assisting in early categorization of ICU patients for rapid appropriate treatment and medico legal aspects.

Keywords:

Systemic inflammatory response syndrome (SIRS) , Sepsis , Mortality , Biomarker , micRNA-۲۲۳ , Prognostic factor