Blood Biomarker and Raman Analysis of Leukocytes in the Multicenter Intelligence Trials: At the Intensive Care Unit (Intelligence-1) and the Emergency Department (Intelligence-2).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Giamarellos-Bourboulis Evangelos J, Thomas-Rüddel Daniel, Pistiki Aikaterini, Ramoji Anuradha, Ryabchykov Oleg, Azam Kazi Sultana Farhana, Toutouzas Konstantinos, Prekates Athanasios, Karatzas Stylianos, Mathas Christos, Kotsaki Antigone, Chalvatzis Stamatios, Antonakos Nikolaos, Damoraki Georgia, Rüger Jan, Knorr Florian, Arend Natalie, Silge Anja, Schie Iwan, Eugen-Olsen Jesper, Bocklitz Thomas, Bauer Michael, Winning Johannes, Kiehntopf Michael, Popp Jürgen, Bloos Frank, Neugebauer Ute
Аннотация
RESULTS: In the INTELLIGENCE studies, 279 patients from six centers in two countries were analyzed, and the Raman spectra of ~1500 leukocytes per patient were measured within only 1 hour. This marks a huge step from bench to bedside regarding usability and technology readiness level of Raman spectroscopy in multicentre clinical trials. With a discriminatory power comparable to individual conventional biomarkers (C-reactive protein, procalcitonin, interleukin-6, and soluble urokinase-type plasminogen activator receptor), the Raman score of leukocytes could not provide added value to the clinical discrimination of sepsis in the INTELLIGENCE-1 study cohorts of intensive care patients with infections. When translating the classification model from INTELLIGENCE-1 to the heterogeneous patient cohort recruited at the emergency department of the double-blinded INTELLIGENCE-2 trial, the Raman score failed to provide added value.
CONCLUSIONS: In theory, Raman assessment of leukocytes might still be a promising tool for sepsis diagnosis and patient stratification, but there is more basic, translational, and clinical research needed to refine its usability and clinical role, probably also taking questions of the pathophysiology of the dysregulated host response for a phenotype stratification into account.