The Role of Antimicrobial Peptides in the Diagnosis of Sepsis

Abstract

Sepsis is the most common cause of death in patients in intensive care units outside the coronary intensive care unit. Early diagnosis and treatment are the most important determinant of prognosis in a positive way, and biomarkers that are developed for the early diagnosis of sepsis are therefore of paramount importance to make necessary interventions and thus reduce mortality. Systemic inflammatory response syndrome (SIRS) criteria, which have been used for many years in the diagnosis of sepsis, have been found to be non-specific for the diagnosis of sepsis and SOFA score indicating organ dysfunction was found to be more useful in diagnosis. But this score, which contains many parameters, cannot facilitate diagnosis because of its long list. Nowadays, rapid and diagnostic tests are needed for the early diagnosis of sepsis. Biomarkers have become a focus of interest in the early diagnosis of sepsis because of their rapid results. In this context, antimicrobial peptides (AMP), which have been studied in recent years on biomarker properties, may be candidate tests in the diagnosis of sepsis. Antimicrobial peptides are important components of natural immunity that can be synthesized by many organisms from bacteria to mammals. These peptides, with broad spectrum microbiocidal activity against viruses, fungi, bacteria and parasites, are excreted in body fluids and inflammation-induced tissues. Antimicrobial peptides such as katelicidin, defensin, calprotectin, hepsidine and lactoferrin, which have been shown to increase synthesis during the sepsis process, are potential biomarkers for this disease. In this review, mechanisms of action and biomarker properties of various AMPs in sepsis process are examined.

Keywords

• Antimicrobial peptides,Biomarkers,Sepsis,SIRS,SOFA

Antimikrobiyal Peptidlerin Sepsis Tanısındaki Rolü

Abstract

Sepsis, koroner yoğun bakım ünitesi dışındaki yoğun bakım ünitelerinde yatan hastalarda ölümün en sık nedenidir. Erken tanı ve tedavi prognozu olumlu yönde belirleyen en önemli etmendir ve bu sebeple sepsisin erken tanısı için geliştirilecek olan biyobelirteçler gerekli müdahalenin yapılması ve böylece mortalitenin azaltılması yönünde öncelik taşımaktadır. Sepsis tanısında, uzun yıllar boyunca kullanılan sistemik inflamatuar yanıt sendromu (SIRS) kriterlerinin, günümüzde sepsis tanısı için spesifik olmadığı anlaşılmış ve tanıda organ disfonksiyonunu gösteren SOFA skoru daha yararlı bulunmuştur. Fakat birçok parametreyi içeren bu skor, uzun listesi nedeni ile tanıda kolaylık sağlayamamaktadır. Günümüzde, sepsis tanısı için hızlı ve tanı koydurucu testlere ihtiyaç duyulmaktadır. Biyobelirteçler, hızlı sonuç sağlamaları nedeni ile sepsisin erken tanısında ilgi odağı haline gelmiştir. Bu bağlamda, son yıllarda biyobelirteç özellikleri üzerinde çalışılan antimikrobiyal peptidler (AMP), sepsisin erken tanısında aday testler olabilir. AMP’ler, bakterilerden memelilere kadar birçok canlı tarafından sentezlenebilen doğal bağışıklığın önemli bileşenleridir. Virüs, mantar, bakteri ve parazitlere karşı oldukça geniş spektrumlu mikrobiyosidal aktiviteye sahip bu peptidler vücut sıvılarında ve inflamasyonun indüklendiği dokularda eksprese edilir. Sepsis sürecinde sentezinin arttığı gözlenen katelisidin, defensin, kalprotektin, hepsidin ve laktoferrin gibi antimikrobiyal peptidler bu hastalık için potansiyel biyobelirteç özelliği göstermektedir. Bu derlemede, AMP’lerden olan katelisidin, defensin, kalprotektin, hepsidin, laktoferrin ve bakterisidal geçirgenlik arttırıcı proteinin (BPI) sepsis sürecindeki etki mekanizmaları ve biyobelirteç özellikleri irdelenmektedir.

Keywords

• Antimikrobiyal peptidler,Biyobelirteçler,Sepsis,SIRS,SOFA

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