A Panel of Urine Derived Biomarkers to Identify and Distinguish Sepsis From Systemic Inflammatory Response Syndrome

Abstract BackgroundSepsis is a fatal condition caused by infection. It is frequently difficult to distinguish sepsis from systemic inflammatory response syndrome (SIRS), often resulting in poor prognoses and the misuse of antibiotics. Hence, highly sensitive and specific biomarkers are needed to differentiate sepsis from SIRS.MethodsUrine samples were collected and segregated by group (sepsis group, SIRS group, healthy control group). iTRAQ was used to identify the differentially expressed protein among the three groups. The identified proteins were measured by ELISA from urine samples. Finally, all the acquired data was analyzed by SPSS.ResultsThe C-reactive protein, leucine-rich alpha glycoprotein-1 and serum amyloid A protein were differentially expressed among the three groups. The adjusted median concentrations of urinary C-reactive protein were 1337.6, 358.7, and 2.4 in the three groups, respectively. The urinary leucine-rich alpha glycoprotein-1 levels were 1614.4, 644.5, and 13.6 respectively. The levels of SAA were 6.3, 2.9, and 0.07, respectively. The sepsis group were higher than SIRS group (P<0.001) and the SIRS group were higher than healthy control group. The sensitivity was 0.906 and the specificity was 0.896 when combining the three biomarkers to distinguish sepsis from SIRS.ConclusionThe urinary C-reactive protein, urinary leucine-rich alpha glycoprotein-1 and urinary SAA has diagnostic value in cases of sepsis. Combining the three biomarkers would greatly improve the sensitivity and specificity of differential diagnoses between sepsis and SIRS.