Sepsis: Traditional and Emergent Biomarkers for Diagnosis and Prognosis

Sepsis and its related complications are associated with significant morbidity and mortality among populations worldwide. Early diagnosis and prompt initial management are keys to improve sepsis outcome. Therefore, biological markers (biomarkers) can be useful for identifying or ruling out sepsis, identifying patients who may benefit from specific therapies or assessing the response to therapy. Although numerous biomarkers have been investigated, only two biomarkers are currently used in the clinical practice, C-reactive protein (CRP) and procalcitonin (PCT). Both were included in 2001 in the revised definition of sepsisas variables to diagnose sepsis, but even these have limited ability to distinguish sepsis from other inflammatory conditions or to predict outcome, and there is a continuous search for better biomarkers of sepsis. Moreover, the recent Third Consensus Definitions for Sepsis and Septic Shock does not include the use of biomarkers as tools for management of sepsis and, probably, to redefine the role of these biomarkers is necessary. The purpose of this review is to describe the most relevant sepsis biomarkers used currently in the clinical practice and discuss the future role of some emergent biomarkers for the management of sepsis.

Keywords: C-reactive protein (CRP), Cytokines, Definitions, Diagnosis, Endocan, Guide antibiotic decisions, Lipopolysaccharide-binding protein (LBP), Mid-regional pro-Adrenomedullin (pro-AMP), Pancreatic Stone Protein (PSP), Pentraxin 3, Presepsin, Procalcitonin (PCT), Prognosis, Sepsis, Septic shock, Soluble E-selectin (sE-selectin), Soluble Intercellular Adhesion Molecule (sICAM-1), Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM- 1), Soluble Vascular Cell Adhesion Molecule (sVCAM-1), Soluble urokinasetype Plasminogen Activator Receptor (suPAR).