Marcadores moleculares en el diagnóstico y pronóstico de sepsis, sepsis grave y choque séptico
Cargando...
Archivos
Fecha
2017
Profesor/a Guía
Facultad/escuela
Idioma
es
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad Nacional de Colombia
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Introducción. A pesar de los importantes avances en el entendimiento de la patofisiología de la sepsis, la mortalidad que genera sigue siendo alta. Objetivo. Describir el estado del arte de los biomarcadores moleculares propuestos hasta el momento como potenciales marcadores para el diagnóstico y pronóstico de sepsis, sepsis grave y choque séptico.Materiales y métodos. Se analizaron los registros de los últimos 14 años que se encontraban en PubMed, en The New England Journal of Medicine (NEJM) y en Illinois Automatic Computer (ILLIAC) con los términos sepsis, genetic polymorphisms, genetic variation y molecular marker. Se clasificaron los artículos por año de publicación y solo se tuvieron en cuenta los publicados durante los últimos 10 años.Resultados. La búsqueda arrojó 3 370 referencias que cubren más de 30 genes con polimorfismos genéticos que pueden ser empleados como potenciales marcadores de polimorfismos. Estos fueron evaluados para su uso en las diferentes manifestaciones de sepsis, su diagnóstico y progresión. Se describen 20 genes marcadores: cuatro asociados con bacteremia (TLR-1, TLR-2, Proteína C y Selectina-E), nueve con sepsis (IL-1B, IL-1A, IL-6, TNF-α, TLR-1, MBL-1, Hsp70, PAI-1 y MIF-1), siete con sepsis grave (IL-1RN, IL-10, TNF-α, CD14, TREM-1, Caspasa 12 y DEFB-1), cinco con choque séptico (TNF-B, TLR-4, Hsp70, MBL-1 y CD14 ) y tres con disfunción multiorgánica (TLR-1, PAI-1 y Proteína C). Conclusión. Los polimorfismos genéticos, en su mayoría, han sido probados clínicamente como marcadores de diagnóstico y pronóstico en la sepsis con resultados prometedores por la alta especificidad y sensibilidad en la práctica clínica.
Introduction: Despite important progress in the understanding of the pathophysiology of sepsis, the mortality rates caused by this condition remain high. Objective: To describe the state of the art on molecular biomarkers proposed as potential markers for the diagnosis and prognosis of sepsis, severe sepsis and septic shock. Materials and methods: The terms sepsis, genetic polymorphisms, genetic variation and molecular marker were analyzed in the records of the last 14 years of PubMed, the New England Journal of Medicine (NEJM) and Illinois Automatic Computer (ILLIAC). The papers were classified by year of publication; only those published within the last 10 years were taken into account. Results: The search yielded 3390 references covering more than 30 genes with genetic polymorphisms that can be used as potential polymorphism markers. They were assessed for use in different manifestations, diagnosis and progression of sepsis. Twenty genetic markers are described: four associated with bacteremia (TLR-1, TLR-2, Protein C and Selectin-E), nine with sepsis (IL-1B, IL-1A, IL-6, TNF-α, TLR-1, MBL-1, Hsp70, PAI-1 and MIF-1), seven with severe sepsis (IL-1RN, IL-10, TNF-α, CD14, TREM-1, Caspase 12 and DEFB-1), five with septic shock (TNF-B, TLR-4, Hsp70, MBL- 1 and CD14), and three with multiorgan dysfunction (TLR-1, PAI-1 and Protein C). Conclusion: In general, genetic polymorphisms have been clinically tested as diagnostic and prognostic markers of sepsis with promising results due to the high specificity and sensitivity of the clinical practice.
Introduction: Despite important progress in the understanding of the pathophysiology of sepsis, the mortality rates caused by this condition remain high. Objective: To describe the state of the art on molecular biomarkers proposed as potential markers for the diagnosis and prognosis of sepsis, severe sepsis and septic shock. Materials and methods: The terms sepsis, genetic polymorphisms, genetic variation and molecular marker were analyzed in the records of the last 14 years of PubMed, the New England Journal of Medicine (NEJM) and Illinois Automatic Computer (ILLIAC). The papers were classified by year of publication; only those published within the last 10 years were taken into account. Results: The search yielded 3390 references covering more than 30 genes with genetic polymorphisms that can be used as potential polymorphism markers. They were assessed for use in different manifestations, diagnosis and progression of sepsis. Twenty genetic markers are described: four associated with bacteremia (TLR-1, TLR-2, Protein C and Selectin-E), nine with sepsis (IL-1B, IL-1A, IL-6, TNF-α, TLR-1, MBL-1, Hsp70, PAI-1 and MIF-1), seven with severe sepsis (IL-1RN, IL-10, TNF-α, CD14, TREM-1, Caspase 12 and DEFB-1), five with septic shock (TNF-B, TLR-4, Hsp70, MBL- 1 and CD14), and three with multiorgan dysfunction (TLR-1, PAI-1 and Protein C). Conclusion: In general, genetic polymorphisms have been clinically tested as diagnostic and prognostic markers of sepsis with promising results due to the high specificity and sensitivity of the clinical practice.
Notas
Indexación: Scopus.
Palabras clave
Sepsis, Biomarcadores, Polimorfismo genético, Polimorfismo de nucleótido simple, Repeticiones de minisatélite
Citación
Revista Facultad de Medicina. Volume 65, Issue 1, 2017, Pages 144-155