Early Diagnosis of Sepsis Using Serum Biomarkers

Terence Chan; Frank Gu

Disclosures

Expert Rev Mol Diagn. 2011;11(5):487-496. 

In This Article

Five-year View

Recent advances in molecular biology and biochemistry will lead to the discovery of new biomarkers for sepsis. The bottleneck challenge in the diagnosis of sepsis is determining the diagnostic relevancy of biomarkers with absolute certainty. The keys to verifying their diagnostic relevancies are standardization in study methodology and use of assays with better detection limits. Assays capable of lower functional detection limits should be readily available for these purposes within the next 5 years as several are already in development, while new technologies will allow improvements to existing ones. The ongoing development of POCT kits for other diseases may also be beneficial for sepsis biomarker research. Designs from these kits can be applied towards developing a sepsis diagnostic kit that may ultimately provide greater accuracy and faster results over current assays. The standardization of study methodology is a complicated task and may not occur within the next 5 years. Researchers should seize the opportunity at current annual conferences on sepsis and biomarker research to achieve some consensus on methodology standards.

In parallel, general consensus in the scientific community regarding the diagnostic relevancies of the current sepsis biomarkers needs to be established within the next few years. Consequently, the direction of research will need to evolve from single-centre to multicentre studies to reduce the limitation of generalization of small data sets. Sepsis often presents alongside other conditions; due to this complexity, a single 'golden' biomarker may not exist, thus research should shift more focus on to assessing the combined diagnostic capabilities of multiple biomarkers.

Complementary research paths also exist and should be explored. Firstly, as sepsis results from systemic infection, the most diagnostically relevant sepsis biomarkers should be studied for their potential towards early diagnosis of general infections. Results from these studies can be applied to the development of POCT kits designed to monitor sudden homeostatic imbalances, indicating that the body is diseased before symptoms are presented. Secondly, some research should be devoted to designing and testing a rigorous, multiplex POCT kit for sepsis within the next 5 years, which would be beneficial for both method standardization in future research and clinical usage in rural and low income communities.

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