Circulating Nucleosomes as a Novel Biomarker for Sepsis: A Scoping Review
Fuhong Su,
Anthony Moreau,
Marzia Savi,
Michele Salvagno,
Filippo Annoni,
Lina Zhao,
Keliang Xie,
Jean-Louis Vincent,
Fabio Silvio Taccone
Affiliations
Fuhong Su
Laboratoire de Recherche Experimentale des Soins Intensifs, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Anthony Moreau
Laboratoire de Recherche Experimentale des Soins Intensifs, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Marzia Savi
Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Michele Salvagno
Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Filippo Annoni
Laboratoire de Recherche Experimentale des Soins Intensifs, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Lina Zhao
Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
Keliang Xie
Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
Jean-Louis Vincent
Laboratoire de Recherche Experimentale des Soins Intensifs, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Fabio Silvio Taccone
Laboratoire de Recherche Experimentale des Soins Intensifs, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, 1070 Brussels, Belgium
Circulating nucleosome levels are commonly elevated in physiological and pathological conditions. Their potential as biomarkers for diagnosing and prognosticating sepsis remains uncertain due, in part, to technical limitations in existing detection methods. This scoping review explores the possible role of nucleosome concentrations in the diagnosis, prognosis, and therapeutic management of sepsis. A comprehensive literature search of the Cochrane and Medline libraries from 1996 to 1 February 2024 identified 110 potentially eligible studies, of which 19 met the inclusion criteria, encompassing a total of 39 SIRS patients, 893 sepsis patients, 280 septic shock patients, 117 other ICU control patients, and 345 healthy volunteers. The enzyme-linked immunosorbent assay [ELISA] was the primary method of nucleosome measurement. Studies consistently reported significant correlations between nucleosome levels and other NET biomarkers. Nucleosome levels were higher in patients with sepsis than in healthy volunteers and associated with disease severity, as indicated by SOFA and APACHE II scores. Non-survivors had higher nucleosome levels than survivors. Circulating nucleosome levels, therefore, show promise as early markers of NETosis in sepsis, with moderate diagnostic accuracy and strong correlations with disease severity and prognosis. However, the available evidence is drawn mainly from single-center, observational studies with small sample sizes and varied detection methods, warranting further investigation.