A Scoping Review of the Transcriptomic Perspective of Sepsis, a Move Towards Improved Precision Medicine?

Abstract

Background Sepsis is a syndromic response to infection that carries a significant global health burden, with 11 million deaths reported globally in 2017. Many biomarkers have been developed over the years for early identification and prognosis in patients with sepsis. However, they lack the sensitivity and specificity for routine use in clinical practice. A significant challenge in developing a sepsis biomarker has been the lack of a robust pathobiological framework: a factor with a weak immunological basis to assess therapeutic efficacy. The transcript can aid in extrapolating immunological changes to the clinical arena. Given that transcriptomic processing forms a part of a systems biology analysis, we undertook to address the question: What is known about the relationship of the transcript to clinical sepsis? Objective Consequently, this review article envisages a systems-based approach to better understand sepsis using mRNA gene expression information. This was achieved through an examination of peer-reviewed literature identifying the relationship of the transcript to clinical sepsis. Methods Information sources included peer-reviewed PubMed-indexed journals using the PubMed database. Articles specific to sepsis were selected, being published between the years 2012 to 2022 inclusive. A content analysis of findings was conducted. Results The search strategy elicited 14,048 studies. Keywords and or mesh terms were applied as single terms or Boolean string search combinations, generating 36 studies. Literature was analyzed concerning the specific use of the transcript and its application to sepsis. Five main descriptive Sepsis categories were identified: (1) Definition; (2) Classification; (3) Severity, (4) Molecular Biomarkers, and (5) Benchmarking. Conclusions Evidence of the connection of the transcript to clinical sepsis was identified. This provided a systems perspective, interfacing transcriptomic data to parameters important in the clinical arena. The use of transcriptomic data in advancing patient sepsis care, thereby aiming to improve precision, requires further investigation.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

There were no funding requirements for this study

Author Declarations

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In this scoping review, information was used that was already in the Public Domain

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

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Data Availability

All cited literature has been used for this scoping review and is available as per the references provided according to journals in the public domain.

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