The Role of Antimicrobial Peptides in the Diagnosis of Sepsis

Yıl 2019, , 1 - 7, 30.04.2019

Tuğba Ayhancı , Mustafa Altındiş

https://doi.org/10.34084/bshr.535317

Cited By: 1

Öz

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.

Anahtar Kelimeler

Antimicrobial peptides, Biomarkers, Sepsis, SIRS, SOFA

Antimikrobiyal Peptidlerin Sepsis Tanısındaki Rolü

Öz

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.

Anahtar Kelimeler

Antimikrobiyal peptidler, Biyobelirteçler, Sepsis, SIRS, SOFA

Kaynakça

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