Non-Coding RNA Networks as Potential Novel Biomarker and Therapeutic Target for Sepsis and Sepsis-Related Multi-Organ Failure

MicroRNA Expression Profile in Patients Admitted to ICU as Novel and Reliable Approach for Diagnostic and Therapeutic Purposes

The ability to detect early metabolic changes in patients who have an increased mortality risk in the intensive care units (ICUs) could increase the likelihood of predicting recovery patterns and assist in disease management. Markers that can predict the disease progression of patients in the ICU might also be beneficial for improving their medical profile. Although biomarkers have been used in the ICU more frequently in recent years, the clinical use of most of them is limited. A wide range of biological processes are influenced by microRNAs (miRNAs) that modulate the translation and stability of specific mRNAs. Studies suggest that miRNAs may serve as a diagnostic and therapeutic biomarker in ICUs by profiling miRNA dysregulation in patient samples. To improve the predictive value of biomarkers for ICU patients, researchers have proposed both investigating miRNAs as novel biomarkers and combining them with other clinical biomarkers. Herein, we discuss recent approaches to the diagnosis and prognosis of patients admitted to an ICU, highlighting the use of miRNAs as novel and robust biomarkers for this purpose. In addition, we discuss emerging approaches to biomarker development and ways to improve the quality of biomarkers so that patients in ICU get the best outcomes possible.

Biomarkers of Sepsis

Sepsis is a highly complex disease caused by a deregulated host's response to infection [...].

The diagnostic value of interleukin 35 as a septic biomarker: A meta-analysis

Background

There is growing evidence that interleukin 35 (IL-35) represents a potential diagnostic biomarker for sepsis. The purpose of this meta-analysis was to evaluate the overall diagnostic accuracy of IL-35 in sepsis.

Materials and methods

From October 1998 to May 2022, set retrieval standards were used to search literature Databases. Each included study was assessed diagnostic accuracy study quality assessment tool. Two researchers independently extracted the data and research features. If there are differences, the issue will be resolved by mutual agreement. Meta-disc and Stata software were utilized to calculate combined sensitivity, specificity, and summary diagnostic odds ratio (SDOR), I2, or Cochrane Q in order to detection for heterogeneity, and meta-regression was performed to figure out the cause of heterogeneity. Utilizing funnel plots, we tested for publication bias.

Results

In this meta-analysis, eight publications were included. The combined sensitivity, specificity, and DOR were 0.87 (95% CI, 0.77–0.93), 0.73 (95% CI, 0.60–0.83), and 18.26 (95% CI, 9.70–34.37), respectively. In addition, 0.88 (95% CI, 0.84–0.90) was the area under the summary receiver operating characteristic curve. In the heterogeneity analysis, the sensitivity of comprehensive I2 statistic was 84.38, and the specificity was 87.82. Deeks’ funnel plot showed no publication bias in this meta-analysis (P = 0.17). A meta-analysis revealed that IL-35 has a modest sensitivity (AUC = 0.88) for diagnosing sepsis. We also compared the diagnostic accuracy of IL-35 and procalcitonin (PCT), and our results showed that the diagnostic accuracy parameters for IL-35 were significantly higher than those for PCT.

Conclusion

Interleukin 35 is a valuable biomarker for the early detection of sepsis. However, the data should be combined with clinical symptoms, signs, and laboratory and microbiological findings.

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

Worldwide, the prevalence of surgery under general anesthesia has significantly increased, both because of modern anesthetic and pain-control techniques and because of better diagnosis and the increased complexity of surgical techniques. Apart from developing new concepts in the surgical field, researchers and clinicians are now working on minimizing the impact of surgical trauma and offering minimal invasive procedures due to the recent discoveries in the field of cellular and molecular mechanisms that have revealed a systemic inflammatory and pro-oxidative impact not only in the perioperative period but also in the long term, contributing to more difficult recovery, increased morbidity and mortality, and a negative financial impact. Detailed molecular and cellular analysis has shown an overproduction of inflammatory and pro-oxidative species, responsible for augmenting the systemic inflammatory status and making postoperative recovery more difficult. Moreover, there are a series of changes in certain epigenetic structures, the most important being the microRNAs. This review describes the most important molecular and cellular mechanisms that impact the surgical patient undergoing general anesthesia, and it presents a series of antioxidant therapies that can reduce systemic inflammation.