A Panel Of Urine Derived Biomarkers To Identify And Distinguish Sepsis From Systemic Inflammatory Response Syndrome

BackgroundSepsis is a fatal disease caused by infection.It is usually a challenge to distinguish the sepsis from SIRS which results in the poor prognosis and the misuse of antibiotics.Hence,the highly sensitive and specific biomarkers are needed to distinguish the sepsis from SIRS.MethodsThe urinary samples were collected by group(Sepsis group,SIRS group,Health control group).iTRAQ was used to identify the differential protein among the three group.Then the identified proteins in urine were measured by ELISA.Finally,all the acquired data was analyzed by SPSS.ResultsThe C-reactive protein,leucine-rich alpha glycoprotein-1 and serum amyloid A protein were the differential protein among the three group.The adjusted median concentrations of urinary C-reactive protein were 1337.6,358.7,2.4 in three group respectively.The urinary leucine-rich alpha glycoprotein-1 were 1614.4,644.5,13.6 respectively.The urinary SAA were 6.3,2.9,0.07 respectively.The Sepsis group were higher than SIRS group(P<0.001)and the SIRS group were higher than Health control group.The sensitivity was 0.906 and the specificity was 0.896 when combined the three biomarkers to distinguish the sepsis from the SIRS.ConclusionThe urinary C-reactive protein,urinary leucine-rich alpha glycoprotein-1 and urinary SAA has diagnostic value to sepsis.Combining the three biomarkers would greatly improve the sensitivity and specificity of differential diagnosis between the sepsis and SIRS.