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Genetic Signature of Sepsis Deciphered - Rapid Diagnostic Test Hopeful

Researchers have discovered a pattern in 11 genes that could make it quick and easy to diagnose sepsis, a serious life-threatening condition.

Sepsis is an extreme inflammatory reaction affecting the entire body and which causes around 37,000 deaths each year in the UK - a rapid diagnostic test could save many of those lives. 'It's critical for clinicians to diagnose sepsis accurately and quickly, because the risk of death from this condition increases with every passing hour it goes untreated,' explained Dr Purvesh Khatri, assistant professor of biomedical informatics research at Stanford University, USA and senior author of the study, which was published in Science Translational Medicine.

Most cases of sepsis are caused by bacterial infection, and if it is caught early it can be treated effectively with antibiotics. But sepsis can be very difficult to recognise, and existing diagnostic tests can be slow or inaccurate. 'Sepsis doesn't lend itself to easy recognition,' said Professor Greg Martin of Emory University, who was not involved in the study. 'Early in its course it is easy to treat but difficult to recognise, and once it has become more recognisable it is incredibly difficult to treat.'

Sepsis is difficult to distinguish from another similar condition - sterile inflammation - which is not caused by an infection. This condition isn't helped by antibiotics, which can actually make it worse.

The Stanford researchers set out to find whether the activity of certain genes was increased in response to sepsis alone. This was a challenging task since around 20,000 genes are known to increase in activity during inflammation. Using information collected from previous studies, they analysed around 2,900 blood samples from almost 1,600 patients, taking into account how soon the blood test was done after the initial injury that caused the sepsis.

'We were able to identify a slight bump in activity of these 11 genes in patients, two to five days prior to their clinical diagnosis,' said Dr Khatri. 'We think we've got the makings of a diagnostic blood test that will allow clinicians to distinguish between these two types of inflammation.' The researchers have filed a patent in association with their findings and are thought to be attempting to develop a rapid diagnostic test for sepsis.

Dr Daniel Henning of the division of emergency medicine at the University of Washington said of the work: 'Overall, the study shows promise for new diagnostic modalities for a common and costly disease. The actual use of gene expression to determine the presence of infection in a clinical setting still has a way to go, however.'

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