Application of peripheral blood protein in the diagnosis of sepsis based on proteomics screening

Objective To explore the value of peripheral blood protein including soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), high mobility group box-1 (HMGB-1), neutrophil gelatinase-associated lipocalin (NGAL), and matrix metalloproteinase-8 (MMP-8) screened by proteomics in the diagnosis of sepsis.

Methods Sixty patients with sepsis admitted to the Central Care Unit of Shanghai Fifth People's Hospital from December 2020 to December 2021 were selected as sepsis group, and 60 patients with non-sepsis infection admitted during the same period were selected as control group. The expression levels of HMGB-1, NGAL, MMP-8, and sTREM-1 in the serum of both patient groups were measured on admission. Variables were subjected to collinearity analysis, and variables with a variance inflation factor (VIF) >10 were excluded. Univariateand multivariate Logistic regression analyses were performed following collinearity diagnosis. Receiver operating characteristic (ROC) curve was used to diagnose sepsis. Correlations of HMGB-1, NGAL, MMP-8, sTREM-1 with Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, Sequential Organ Failure Assessment (SOFA) score, procalcitonin (PCT), and C-reactive protein were analyzed using Spearman analysis.

Results The expression levels of HMGB-1, NGAL, MMP-8, and sTREM-1 in the sepsis group were significantly higher than those in the control group (P < 0.05). Collinearity analysis showed that HMGB-1, NGAL, MMP-8, and sTREM-1 had low collinearity. Univariate and multivariate Logistic regression analyses revealed that NGAL and MMP-8 were independent predictors of sepsis. The area under the curve (AUC) for NGAL, MMP-8, white blood cells count, and PCT were 0.95(95%CI, 0.91 to 0.99), 0.80 (95%CI, 0.71 to 0.89), 0.89 (95%CI, 1.00 to 1.09) and 0.96 (95%CI, 1.07 to 1.17), respectively. Plasma sTREM-1, NGAL, HMGB-1, and MMP-8 were all respectively positively correlated with CRP, PCT, SOFA score, and APACHEⅡ score (P < 0.01).

Conclusion The levels of sTREM-1, NGAL, HMGB-1, and MMP-8 are higher in the sepsis patients. In addition, NGAL and MMP-8 are independent predictors of sepsis.