Interleukin-37 As A Biomarker Of Mortality Risk In Patients With Sepsis

Background: Sepsis is a serious syndrome that is caused by an unbalanced inflammatory response to infection and can cause high mortality.The role of interleukin-37(IL-37)in estimating the mortality in patients with sepsis remains unknown.This study aims to reveal the clinical application of IL-37 as a potentially novel biomarker to predict mortality risk in patients with sepsis.Methods: The serum IL-37 level in 114 adult septic patient serum samples on the day of intensive care unit(ICU)admission,56 non-sepsis ICU patients,and 56 healthy volunteers were measured and analyzed,and the 28-day survival status and sequential organ failure assessment(SOFA)scores of the participants were compared.Furthermore,the area under the receiver operating characteristic curve(AUC)of IL-37,IL-6,and SOFA at ICU admission for 28-day survival was used to evaluate the ability of IL-37 in predicting the mortality of sepsis.Results: The serum IL-37 level at admission was elevated in patients with sepsis.Moreover,the concentration of IL-37 in patients with sepsis was significantly higher than that in non-sepsis ICU patients and the healthy control group.In addition,the concentration of serum IL-37 in non-surviving patients with sepsis was significantly higher than that in survivors.In patients with sepsis on the day of ICU admission,the AUC associated with 28-day mortality was 0.67(p = 0.0022;95% confidence interval [95% CI],0.57–0.77)for IL-37,0.75(p < 0.0001;95% CI,0.66–0.84)for SOFA,and 0.62(p = 0.0342;95% CI,0.51–0.72)for IL-6.IL-37 and SOFA scores on the day of ICU admission of the patients with sepsis were found to be independent predictors of 28-day mortality,whereas IL-6 was not.The risk of mortality in patients with sepsis and high serum IL-37 concentration(≥107.05pg/ml)was 4.6 times that of patients with sepsis and low serum concentration.The AUC of IL-37 combined with SOFA-estimated 28-day mortality in patients with sepsis increased from 0.67(p = 0.0022,95% CI,0.57–0.77)to 0.80(p < 0.0001,95% CI,0.711–0.879).In addition,patients with sepsis and high serum IL-37concentrations(≥107.05pg/ml)had poorer survival rate than those with low serum concentrations(<107.05pg/ml).Conclusion: IL-37 concentrations at ICU admission are valuable for predicting the 28-day mortality risk of patients with sepsis,suggesting that IL-37 may be a novel biomarker.These findings can be used as a basis for guiding early clinical decision-making in treating patients with sepsis.