Development and Diagnostic Validation of an Automated Rapid Testing Platform for Serum Lysophosphatidylcholine as a Sepsis Biomarker.

BACKGROUND

Sepsis is a life-threatening condition, requiring timely diagnosis and reliable biomarkers for effective management. Lysophosphatidylcholine (LPC) has emerged as a promising biomarker; however, conventional quantification methods, such as liquid chromatography- tandem mass spectrometry (LC-MS/MS), are time-consuming and resource-intensive. We developed and validated an automated rapid testing platform based on enzymatic spectrophotometry for serum LPC quantification.

METHODS

Serum LPC was quantified using an automated rapid testing platform based on enzymatic hydrogen peroxide generation, detected colorimetrically with the chromogen DA-67. Analytical accuracy was evaluated through method comparison with ultraviolet-visible spectrophotometry (N=35 samples) and an LC-MS/MS (N=120 samples). Participants were classified into sepsis and septic shock (N=35), systemic inflammatory response syndrome (SIRS, N=10), and healthy controls (N=75). Statistical analyses included logistic regression, ROC analysis, and Kaplan-Meier survival analysis.

RESULTS

The automated rapid testing platform reflected LPC concentration-dependent absorbance changes and differentiated clinical groups. Serum LPC concentrations were significantly lower in patients with sepsis or septic shock than in healthy controls and patients with SIRS (all P <0.05). We observed strong concordance with LC-MS/MS data (r=0.99) and significant correlations with C-reactive protein concentrations and white blood cell counts. Low LPC concentrations were independently associated with 90-day mortality.

CONCLUSIONS

Our platform enables rapid and accurate LPC measurements with minimal sample requirements, facilitating diagnosis and risk stratification and paving the way for more individualized and timely care for patients with sepsis.