TITLE:
A Review on the Use of Biomarkers for Early Diagnosis of Sepsis and Associated Hemostatic Abnormalities
AUTHORS:
Ayomide Babatunde Ishola, Abdulrahman Opeyemi Abdulbasit
KEYWORDS:
Sepsis, Coagulopathy, Biomarkers, DIC, Presepsin, Angiopoietin-2, NETs
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.15 No.2,
May
30,
2025
ABSTRACT: Sepsis-related haemostatic disorders, especially disseminated intravascular coagulation (DIC), substantially impact morbidity and mortality; nevertheless, early diagnosis is difficult due to the absence of precise biomarkers. This study assesses novel biomarkers that connect immunological dysregulation and coagulation pathways, presenting opportunities for prompt detection and enhanced therapy. Proinflammatory cytokines (IL-6, TNF-α) and D-dimer are fundamental indicators, however they lack specificity. Emerging biomarkers such as presepsin (sCD14-ST), indicative of bacterial phagocytosis and predictive of coagulopathy within 24 hours, and interleukin-27 (IL-27), possessing both pro- and anti-inflammatory characteristics, provide enhanced diagnostic precision compared to traditional markers. Angiopoietin-2 (Ang-2), a principal modulator of endothelial dysfunction, exhibits a robust correlation with the risk of disseminated intravascular coagulation (DIC) (OR >5) and death, whereas neutrophil extracellular traps (NETs) and their constituents (e.g., citrullinated histones) establish mechanistic connections between thromboinflammation and organ failure. Neutrophil CD64 (nCD64), which is swiftly increased during bacterial sepsis, provides great specificity (>90%) for the detection of infections. These biomarkers target essential deficiencies in sepsis management, encompassing early diagnosis, dynamic risk stratification, and therapeutic monitoring. Obstacles persist in standardisation and clinical use; nonetheless, including these indicators in multimodal panels or point-of-care systems has the potential to transform sepsis management. Future research should concentrate on substantiating their efficacy in directing specific therapy, such as immunomodulation or anticoagulation, to alleviate sepsis-induced coagulopathy and enhance outcomes.