Langley R J, et al., An Integrated Clinico-Metabolomic Model Improves Prediction of Death in Sepsis. Science Translational Medicine, 2013. 5(195): 195ra95.
Metabolon results led to:
- Biomarkers for identifying sepsis patients who merit intensive treatment due to risk of death
Key metabolomic observations:
- Fatty acid transport and b-oxidation, gluconeogenesis, and the citric acid cycle alterations
Editor’s Summary: Understanding Survival of the Fittest in Sepsi.
Differentiating mild infections from life-threatening ones is a complex decision that is made millions of times a year in U.S. emergency rooms. Should a patient be sent home with antibiotics and chicken soup? Or should he or she be hospitalized for intensive treatment? Sepsis—a serious infection that is associated with a generalized inflammatory response—is one of the leading causes of death. In two prospective clinical studies reported by Langley et al., patients arriving at four urban emergency departments with symptoms of sepsis were evaluated clinically and by analysis of their plasma proteome and metabolome. Survivors and nonsurvivors at 28 days were compared, and a molecular signature was detected that appeared to differentiate these outcomes—even as early as the time of hospital arrival. The signature was part of a large set of differences between these groups, showing that better energy-producing fatty acid catabolism was associated with survival of the fittest in sepsis. A test developed from the signature was able to predict sepsis survival and nonsurvival reproducibly and better than current methods. This test could help to make all important decisions in the emergency room more accurate.