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Bitsadze V, Lazarchuk A, Vorobev A, Khizroeva J, Tretyakova M, Makatsariya N, Gashimova N, Grigoreva K, Tatarintseva A, Karpova A, Mostovoi A, Zainulina M, Kapanadze D, Blbulyan A, Kuneshko N, Gris JC, Elalamy I, Gerotziafas G, Makatsariya A. Systemic Inflammatory Response Syndrome, Thromboinflammation, and Septic Shock in Fetuses and Neonates. Int J Mol Sci 2025; 26:3259. [PMID: 40244141 PMCID: PMC11989690 DOI: 10.3390/ijms26073259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2025] [Revised: 03/24/2025] [Accepted: 03/28/2025] [Indexed: 04/18/2025] Open
Abstract
This article explores systemic inflammatory response syndrome (SIRS), thromboinflammation, and septic shock in fetuses and neonates, offering a comprehensive examination of their pathophysiology, diagnostic criteria, and clinical implications. It identifies SIRS as an exaggerated response to external stress, disrupting the balance between inflammation and adaptive mechanisms, driven by cytokines such as TNF-α and IL-1. The fetal inflammatory response syndrome (FIRS), a subset of SIRS, is noted for its role in adverse neonatal outcomes, including organ damage, inflammation, and long-term developmental disorders. The article discusses the extensive effects of FIRS on critical systems, including the blood, lungs, central nervous system, and kidneys. It highlights the challenges in diagnosing and managing septic shock in neonates, focusing on the relationship between inflammation and the hemostatic system. Additionally, the paper points out recent advancements, such as the convergent model of coagulation and emerging biomarkers like microRNAs for early detection. Despite this progress, gaps remain in understanding the molecular mechanisms underlying these conditions and in developing effective therapeutic strategies. This highlights the necessity for targeted research to mitigate the morbidity and mortality associated with septic shock in neonates.
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Affiliation(s)
- Victoria Bitsadze
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Arina Lazarchuk
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Alexander Vorobev
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Jamilya Khizroeva
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Maria Tretyakova
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Natalia Makatsariya
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Nilufar Gashimova
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Kristina Grigoreva
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Alena Tatarintseva
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
| | - Anna Karpova
- Vorokhobov City Clinical Hospital No 67, Moscow Healthcare Department, 2/44 Salyama Adilya Str., Moscow 123423, Russia; (A.K.); (A.M.)
- Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation, 2/1 bldg. 1, Barrikadnaya Str., Moscow 123993, Russia
- Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry of Institute of Postgraduate Education of Yaroslavl State Medical University, Yaroslavl State Medical University, Health Ministry of Russian Federation, 5 Revolutsionnaya Str., Yaroslavl 150000, Russia
| | - Aleksei Mostovoi
- Vorokhobov City Clinical Hospital No 67, Moscow Healthcare Department, 2/44 Salyama Adilya Str., Moscow 123423, Russia; (A.K.); (A.M.)
- Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation, 2/1 bldg. 1, Barrikadnaya Str., Moscow 123993, Russia
- Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry of Institute of Postgraduate Education of Yaroslavl State Medical University, Yaroslavl State Medical University, Health Ministry of Russian Federation, 5 Revolutsionnaya Str., Yaroslavl 150000, Russia
| | - Marina Zainulina
- Snegirev Maternity Hospital No 6, 5 Mayakovskogo Str., Saint Petersburg 192014, Russia;
- Department of Obstetrics, Gynecology and Reproductology of Pavlov First Saint Petersburg State Medical University, Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation, 6/8 Lev Tolstoy Str., Saint Petersburg 197022, Russia
| | - Daredzhan Kapanadze
- Center of Pathology of Pregnancy and Hemostasis «Medlabi», 340112 Tbilisi, Georgia;
| | - Armen Blbulyan
- Research Center of Maternal and Child Health Protection, 22 Mashtots Avenue, Yerevan 0002, Armenia;
| | - Nart Kuneshko
- Moscow’s Region Odintsovo Maternity Hospital, Odintsovo 143003, Russia;
| | - Jean-Christophe Gris
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
- Faculty of Pharmaceutical and Biological Sciences, Montpellier University, 34093 Montpellier, France
| | - Ismail Elalamy
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
- Faculté Privee de Médecine de Marrakech (FPMM), Route Amizmiz, Marrakech 42312, Morocco
- Hopital Americain de Paris, 55 rue du Château, Neuilly Sur Seine, 92200 Paris, France
| | - Grigoris Gerotziafas
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
- INSERM UMR_S_938, Saint-Antoine Research Center (CRSA), Team “Cancer Biology and Therapeutics”, Group “Cancer—Angiogenesis—Thrombosis”, University Institute of Cancerology (UIC), Sorbonne University, 34 Rue du Crozatier, 75012 Paris, France
- Thrombosis Center, Tenon—Saint Antoine University Hospital, Hôpitaux Universitaires Est Parisien, Assitance Publique Hôpitaix de Paris (AP-HP), 4 Rue de la Chine, 75020 Paris, France
| | - Alexander Makatsariya
- Department of Obstetrics, Gynecology and Perinatal Medicine, The I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str 8-2, Moscow 119435, Russia; (V.B.); (A.L.); (A.V.); (M.T.); (N.M.); (N.G.); (K.G.); (A.T.); (J.-C.G.); (I.E.); (G.G.); (A.M.)
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Jin Y, Zhang Y, Li Y, Zheng X. Significances of miRNAs for predicting sepsis mortality: a meta-analysis. Front Microbiol 2025; 16:1472124. [PMID: 40135054 PMCID: PMC11933020 DOI: 10.3389/fmicb.2025.1472124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Accepted: 02/19/2025] [Indexed: 03/27/2025] Open
Abstract
Background Sepsis is a life-threatening condition caused by a dysregulated immune response to infection and remains a major cause of mortality in intensive care units (ICUs). Recent studies have identified microRNAs (miRNAs), a class of small RNA molecules, as potential biomarkers for diagnosing and predicting outcomes in sepsis patients. However, the results of these studies have been inconsistent. This meta-analysis aims to comprehensively evaluate the diagnostic and prognostic value of miRNAs in predicting sepsis-related mortality. Methods A comprehensive literature search was performed across major databases, including PubMed, Cochrane Library, EMBASE, and CNKI, up to April 7, 2024. Data extraction and meta-analysis were conducted using Meta-disk 1.4 and STATA 15.1, employing both fixed- and random-effects models to ensure robust statistical analysis. Results A total of 55 studies met the inclusion criteria and were analyzed. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve for miRNA detection were calculated. The overall performance of total miRNA detection demonstrated a sensitivity of 0.76 (95% confidence interval [CI]: 0.74-0.77), a specificity of 0.72 (95% CI: 0.71-0.73), and an SROC value of 0.83. Subgroup analyses revealed that miR-133a-3p exhibited the highest diagnostic accuracy, with a pooled sensitivity of 0.83 (95% CI: 0.70-0.92), specificity of 0.79 (95% CI: 0.71-0.86), and an SROC value of 0.90. Additionally, other miRNAs, including miR-146a, miR-21, miR-210, miR-223-3p, miR-155, miR-25, miR-122, miR-125a, miR-125b, and miR-150, also demonstrated high SROC values (0.84 to 0.76). Conclusion This meta-analysis underscores the potential of several microRNAs (miRNAs) as reliable biomarkers for predicting sepsis mortality. Specifically, miR-133a-3p, miR-146a, miR-21, miR-210, miR-223-3p, miR-155, miR-25, miR-122, miR-125b, and miR-150 emerge as promising candidates for clinical applications in sepsis prognosis.
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Affiliation(s)
| | | | | | - Xiaolan Zheng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
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Loi MV, Sultana R, Nguyen TM, Tia ST, Lee JH, O’Connor D. The Diagnostic Utility of Host RNA Biosignatures in Adult Patients With Sepsis: A Systematic Review and Meta-Analysis. Crit Care Explor 2025; 7:e1212. [PMID: 39888601 PMCID: PMC11789890 DOI: 10.1097/cce.0000000000001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2025] Open
Abstract
OBJECTIVES Sepsis is a life-threatening medical emergency, with a profound healthcare burden globally. Its pathophysiology is complex, heterogeneous and temporally dynamic, making diagnosis challenging. Medical management is predicated on early diagnosis and timely intervention. Transcriptomics is one of the novel "-omics" technologies being evaluated for recognition of sepsis. Our objective was to evaluate the performance of host gene expression biosignatures for the diagnosis of all-cause sepsis in adults. DATA SOURCES PubMed/Ovid Medline, Ovid Embase, and Cochrane databases from inception to June 2023. STUDY SELECTION We included studies evaluating the performance of host gene expression biosignatures in adults who were diagnosed with sepsis using existing clinical definitions. Controls where applicable were patients without clinical sepsis. DATA EXTRACTION Data including population demographics, sample size, study design, tissue specimen, type of transcriptome, health status of comparator group, and performance of transcriptomic biomarkers were independently extracted by at least two reviewers. DATA SYNTHESIS Meta-analysis to describe the performance of host gene expression biosignatures for the diagnosis of sepsis in adult patients was performed using the random-effects model. Risk of bias was assessed according to the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A total of 117 studies (n = 17,469), comprising 132 separate patient datasets, were included in our final analysis. Performance of transcriptomics for the diagnosis of sepsis against pooled controls showed area under the receiver operating characteristic curve (AUC, 0.86; 95% CI, 0.84-0.88). Studies using healthy controls showed AUC 0.87 (95% CI, 0.84-0.89), while studies using controls with systemic inflammatory response syndrome (SIRS) had AUC 0.84 (95% CI, 0.78-0.90). Transcripts with excellent discrimination against SIRS controls include UrSepsisModel, a 210 differentially expressed genes biosignature, microRNA-143, and Septicyte laboratory. CONCLUSIONS Transcriptomics is a promising approach for the accurate diagnosis of sepsis in adults and demonstrates good discriminatory ability against both healthy and SIRS control subjects.
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Affiliation(s)
- Mervin V. Loi
- Department of Paediatric Subspecialties, Children’s Intensive Care Unit, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Rehena Sultana
- Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tuong Minh Nguyen
- Department of Industrial Systems Engineering and Management, College of Design and Engineering, National University of Singapore, Singapore, Singapore
| | - Shi Ting Tia
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Jan Hau Lee
- Department of Paediatric Subspecialties, Children’s Intensive Care Unit, KK Women’s and Children’s Hospital, Singapore, Singapore
- SingHealth-Duke NUS Paediatrics Academic Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Daniel O’Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
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Lin Y, Ma L, Dan H, Chen G, Dai J, Xu L, Liu Y. MiR-107-3p Knockdown Alleviates Endothelial Injury in Sepsis via Kallikrein-Related Peptidase 5. J Surg Res 2023; 292:264-274. [PMID: 37666089 DOI: 10.1016/j.jss.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Endothelial injury is a major characteristic of sepsis and contributes to sepsis-induced multiple-organ dysfunction. In this study, we investigated the role of miR-107-3p in sepsis-induced endothelial injury. METHODS Human umbilical vein endothelial cells (HUVECs) were exposed to 20 μg/mL of lipopolysaccharide (LPS) for 6-48 h. The levels of miR-107-3p and kallikrein-related peptidase 5 (KLK5) were examined. HUVECs were treated with LPS for 12 h and subsequently transfected with miR-107-3p inhibitor, KLK5 siRNA, or cotransfected with KLK5 siRNA and miR-107-3p inhibitor/negative control inhibitor. Cell survival, apoptosis, invasion, cell permeability, inflammatory response, and the Toll-like receptor 4/nuclear factor κB signaling were evaluated. In addition, the relationship between miR-107-3p and KLK5 expression was predicted and verified. RESULTS LPS significantly elevated miR-107-3p levels, which peaked at 12 h. Conversely, the KLK5 level was lower in the LPS group than in the control group and was lowest at 12 h. MiR-107-3p knockdown significantly attenuated reductions in cell survival and invasion, apoptosis promotion, hyperpermeability and inflammation induction, and activation of the NF-κB signaling caused by LPS. KLK5 knockdown had the opposite effect. Additionally, KLK5 was demonstrated as a target of miR-107-3p. MiR-107-3p knockdown partially reversed the effects of KLK5 depletion in LPS-activated HUVECs. CONCLUSIONS Our findings indicate that miR-107-3p knockdown may protect against sepsis-induced endothelial cell injury by targeting KLK5. This study identified a novel therapeutic target for sepsis-induced endothelial injury.
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Affiliation(s)
- Yongbo Lin
- Department of Cardiology, People's Hospital of Dongxihu District, Wuhan, China
| | - Li Ma
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Hanliang Dan
- Department of Cardiology, People's Hospital of Dongxihu District, Wuhan, China
| | - Gang Chen
- Department of ICU, Wuhan Wuchang Hospital, Wuhan, China
| | - Jian Dai
- Department of ICU, Wuhan Wuchang Hospital, Wuhan, China
| | - Liang Xu
- Department of ICU, Wuhan Wuchang Hospital, Wuhan, China.
| | - Yuqi Liu
- Department of Respiratory and Critical Care Medicine, 2nd Affiliated Hospital of Fujian Medical University, Quanzhou, China.
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