Exploring proteomic signatures in sepsis and non-infectious systemic inflammatory response syndrome

Background: The search for new biomarkers that allow an early diagnosis in sepsis has become a necessity in medicine. The objective of this study is to identify potential protein biomarkers of differential expression between sepsis and non-infectious systemic inflammatory response syndrome (NISIRS). Methods: Prospective observational study of a cohort of septic patients activated by the Sepsis Code and patients admitted with NISIRS, during the period 2016-2017. A mass spectrometry-based approach was used to analyze the plasma proteins in the enrolled subjects. Subsequently, using recursive feature elimination (RFE) classification and cross-validation with a vector classifier, an association of these proteins in patients with sepsis compared to patients with NISIRS. The protein-protein interaction network was analyzed with String software. Results: A total of 277 patients (141 with sepsis and 136 with NISIRS) were included. After performing RFE, 25 proteins in the study patient cohort showed statistical significance, with an accuracy of 0.960, specificity of 0.920, sensitivity of 0.973, and an AUC of 0.985. Of these, 14 proteins (vWF, PPBP, C5, C1RL, FCN3, SAA2, ORM1, ITIH3, GSN, C1QA, CA1, CFB, C3, LBP) have a greater relationship with sepsis while 11 proteins (FN1, IGFALS, SERPINA4, APOE, APOH, C6, SERPINA3, AHSG, LUM, ITIH2, SAA1) are more expressed in NISIRS.