Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk

Ma Jin, Yang Hao, Sun Changrui, Lei Yu, Wu Chunxiang

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Journal of Chongqing Medical University ›› 2024, Vol. 49 ›› Issue (12) : 1600-1607. DOI: 10.13406/j.cnki.cyxb.003678
Clinical research

Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk

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Abstract

Objective To investigate the cytometric bead array（CBA） method in measuring the expression levels of human cytokine profiles in patients with sepsis，and to explore the clinical application value of different cytokines in the early diagnosis of sepsis and the prediction of mortality risk. Methods This study was conducted among 256 sepsis patients admitted to the intensive care unit （ICU），99 healthy individuals who underwent physical examination，and 99 non-sepsis patients admitted to the ICU，and the CBA method was used to measure the plasma levels of interleukin-2（IL-2），interleukin-4 （IL-4），interleukin-6（IL-6），interleukin-10 （IL-10），tumor necrosis factor-α（TNF-α），and interferon gamma（IFN-γ）. The Spearman and Mantel tests in R language were used for the routine correlation analysis and the correlation analysis between indicator sets，and the receiver operating characteristic（ROC） curve was plotted to assess the application value of each cytokine in the human cytokine profile in the early diagnosis of sepsis patients and the prediction of mortality risk. Results The sepsis patients had significantly higher plasma levels of IL-6 and IL-10 in the human cytokine profile than the healthy controls and the non-sepsis patients admitted to the ICU. IL-6 had an area under the ROC curve（AUC） of 0.868（95%CI=0.835-0.901，P<0.000 1） in the early diagnosis of sepsis，while IL-10 had an AUC of 0.831（95%CI= 0.793-0.869，P<0.000 1）. The correlation analysis of the indicator sets using the Mantel test showed a significant correlation between IL-6 and C-reactive protein in the sepsis mortality group（r=0.101，P=0.001），as well as a significant correlation between IL-10 and neutrophil count（r=0.132，P=0.001）. All cytokines in the human cytokine profile had an AUC of <0.70 in predicting 28-day mortality rate. Conclusion Human cytokines measured by the CBA method have varying degrees of efficacy in the early diagnosis of sepsis. While IL-6 and IL-10 can offer valuable evidence for the early clinical diagnosis of sepsis，they have comparable efficacy to other cytokines in predicting mortality risk

Key words

cytokine profile / septic prognosis / interleukin-6 / interleukin-10 / biomarkers

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Ma Jin , Yang Hao , Sun Changrui , et al . Clinical application of flow cytometric cytokine profiling in diagnosis of sepsis and assessment of mortality risk. Journal of Chongqing Medical University. 2024, 49(12): 1600-1607 https://doi.org/10.13406/j.cnki.cyxb.003678

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