Characterization of sepsis inflammatory endotypes using circulatory proteins in patients with severe infection: a prospective cohort study.

Endotypes Hyperinflammation Proteomics Sepsis Severe infections

Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
08 Oct 2022
Historique:
received: 08 04 2022
accepted: 26 09 2022
entrez: 8 10 2022
pubmed: 9 10 2022
medline: 12 10 2022
Statut: epublish

Résumé

Sepsis is a heterogeneous syndrome due to a variable range of dysregulated processes in the host immune response. Efforts are made to stratify patients for personalized immune-based treatments and better prognostic prediction. Using gene expression data, different inflammatory profiles have been identified. However, it remains unknown whether these endotypes mirror inflammatory proteome profiling, which would be more feasible to assess in clinical practice. We aim to identify different inflammatory endotypes based on circulating proteins in a cohort of moderately ill patients with severe infection (Sepsis-2 criteria). In this prospective study, 92 inflammatory plasma markers were profiled using a targeted proteome platform and compared between patients with severe infection (Sepsis-2 criteria) and healthy controls. To identify endotypes with different inflammatory profiles, we performed hierarchical clustering of patients based on the differentially expressed proteins, followed by clinical and demographic characterization of the observed endotypes. In a cohort of 167 patients with severe infection and 192 healthy individuals, we found 62 differentially expressed proteins. Inflammatory proteins such as TNFSF14, OSM, CCL23, IL-6, and HGF were upregulated, while TRANCE, DNER and SCF were downregulated in patients. Unsupervised clustering identified two different inflammatory profiles. One endotype showed significantly higher inflammatory protein abundance, and patients with this endotype were older and showed lower lymphocyte counts compared to the low inflammatory endotype. By identifying endotypes based on inflammatory proteins in moderately ill patients with severe infection, our study suggests that inflammatory proteome profiling can be useful for patient stratification.

Sections du résumé

BACKGROUND BACKGROUND
Sepsis is a heterogeneous syndrome due to a variable range of dysregulated processes in the host immune response. Efforts are made to stratify patients for personalized immune-based treatments and better prognostic prediction. Using gene expression data, different inflammatory profiles have been identified. However, it remains unknown whether these endotypes mirror inflammatory proteome profiling, which would be more feasible to assess in clinical practice. We aim to identify different inflammatory endotypes based on circulating proteins in a cohort of moderately ill patients with severe infection (Sepsis-2 criteria).
METHODS METHODS
In this prospective study, 92 inflammatory plasma markers were profiled using a targeted proteome platform and compared between patients with severe infection (Sepsis-2 criteria) and healthy controls. To identify endotypes with different inflammatory profiles, we performed hierarchical clustering of patients based on the differentially expressed proteins, followed by clinical and demographic characterization of the observed endotypes.
RESULTS RESULTS
In a cohort of 167 patients with severe infection and 192 healthy individuals, we found 62 differentially expressed proteins. Inflammatory proteins such as TNFSF14, OSM, CCL23, IL-6, and HGF were upregulated, while TRANCE, DNER and SCF were downregulated in patients. Unsupervised clustering identified two different inflammatory profiles. One endotype showed significantly higher inflammatory protein abundance, and patients with this endotype were older and showed lower lymphocyte counts compared to the low inflammatory endotype.
CONCLUSIONS CONCLUSIONS
By identifying endotypes based on inflammatory proteins in moderately ill patients with severe infection, our study suggests that inflammatory proteome profiling can be useful for patient stratification.

Identifiants

pubmed: 36209073
doi: 10.1186/s12879-022-07761-0
pii: 10.1186/s12879-022-07761-0
pmc: PMC9547371
doi:

Substances chimiques

Biomarkers 0
Interleukin-6 0
Proteome 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

778

Subventions

Organisme : European Society of Clinical Microbiology and Infectious Diseases
ID : 2017
Organisme : Radboud Universitair Medisch Centrum
ID : Hypatia Grant 2018
Organisme : ZonMw
ID : ZonMw COVID-19
Pays : Netherlands
Organisme : Romanian Ministry of European Funds
ID : FUSE
Organisme : European Research Council
ID : 833247
Pays : International
Organisme : Nederlandse Organisatie voor Wetenschappelijk Onderzoek
ID : Spinoza Grant

Informations de copyright

© 2022. The Author(s).

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Auteurs

Isis Ricaño-Ponce (I)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands. Isis.RicanoPonce@radboudumc.nl.

Anca-Lelia Riza (AL)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.
Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

Aline H de Nooijer (AH)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.

Andrei Pirvu (A)

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

Stefania Dorobantu (S)

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

Adina Dragos (A)

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

Ioana Streata (I)

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

Mihaela Roskanovic (M)

Hospital for Infectious Diseases and Pneumology "Victor Babeş" Craiova, Craiova, Romania.
Infectious Disease Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania.

Inge Grondman (I)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.

Florentina Dumitrescu (F)

Hospital for Infectious Diseases and Pneumology "Victor Babeş" Craiova, Craiova, Romania.
Infectious Disease Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania.

Vinod Kumar (V)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.
Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Mihai G Netea (MG)

Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.
Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany.

Mihai Ioana (M)

Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Regional Centre of Medical Genetics Dolj, County Clinical Emergency Hospital Craiova, Craiova, Romania.

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