Serum decoy receptor 3, a potential new biomarker for sepsis

Background: Sepsis, a common deadly systemic infection caused by a variety of pathogens, has some clinical symptoms similar to the systemic inflammatory response syndrome (SIRS), a whole-body non-infectious inflammatory reaction to severe insults, such as burn, trauma, hypotensive shock and so on. Treatment of sepsis depends mainly on anti-microbial, while remedy for SIRS might require steroids that could possibly enhance the spread of microbes. Unfortunately, it is very difficult to distinguish these two completely different serious conditions without blood culture, which takes days to grow and identify causative pathogens. We examined a biomarker, serum decoy receptor 3 (DcR3), was evaluated for its utility in the differential diagnosis between sepsis and SIRS. Methods: Serum DcR3 level in 118 healthy controls, 24 sepsis patients and 43 SIRS patients, was quantitatively measured by enzyme-linked immunosorbent assay (ELISA). Results: The serum DcR3 was significantly increased in sepsis patients compared with SIRS patients and healthy controls (6.11 +/- 2.58 ng/ml vs 2.62 +/- 1.46 ng/ml, and 0.91 +/- 0.56 ng/ml, respectively, p < 0.001). The areas under the receiver operating characteristic curve of DcR3 for the normal vs. SIRS, normal vs. sepsis and SIRS vs. sepsis were 0.910 (0.870-0.950), 0.992 (0.984-1.000) and 0.896 (0.820-0.973). respectively. In addition, the DcR3 exhibited a positive correlation coefficient with APACHE II score, a most commonly used index for the severity of sepsis (r = 0.556, p = 0.005). Conclusion: The serum DcR3 has a potential to serve as a new biomarker for sepsis with its high specificity and sensitivity. (C) 2012 Elsevier B.V. All rights reserved.