• Raquel Almansa, María Heredia-Rodríguez, Esther Gomez-Sanchez, David Andaluz-Ojeda, Verónica Iglesias, Lucia Rico, Alicia Ortega, Estefanía Gomez-Pesquera, Pilar Liu, Marta Aragón, Jose Maria Eiros, Maria Ángeles Jiménez-Sousa, Salvador Resino, Ignacio Gómez-Herreras, Jesús F Bermejo-Martín, and Eduardo Tamayo.
• Grupo de Investigación Biomédica en Cuidados Críticos (BioCritic), Hospital Clínico Universitario de Valladolid, SACYL/IECSYL, Avenida Ramón y Cajal, 3, 47005 Valladolid, Spain; Unidad Apoyo a la Investigación, Hospital Clínico Universitario de Valladolid, SACYL/IECSYL, Avenida Ramón y Cajal, 3, 47005 Valladolid, Spain. Electronic address: ralmansa@saludcastillayleon.es.
• J. Infect. 2015 May 1; 70 (5): 445-56.

ObjectivesSepsis is characterised by the frequent presence of organ failure and marked immunologic alterations. We studied the association between the extent of organ failure and the transcriptomic response of septic patients.MethodsGene expression profiles in the blood of 74 surgical patients with sepsis were compared with those of 30 surgical patients with no sepsis. Differentially expressed genes were assessed for their correlation with the sequential organ failure (SOFA) score.ResultsThe expression levels of a group of genes participating in the cell cycle (HIST1H1C, CKS2, CCNA2, CDK1, CCNB2, CIT, CCNB1, AURKA, RAD51), neutrophil protease activity (ELANE, ADORA3, MPO, MMP8, CTSG), IL-1R and IL-18R response correlated directly with SOFA and mortality. Genes involved in T cell (LCK, CD3G, CD3D, ZAP70, ICOS, CD3E, CD28, IL2RB, CD8B, CD8A, CD40LG, IL23A, CCL5, SH2D1A, ITK, CD247, TBX21, GATA3, CCR7, LEF1, STAT4) and NK cell immunity (CD244, KLRK1, KLRD1) were inversely associated with SOFA and mortality.ConclusionsThe extent of organ failure in sepsis correlates directly with the existence of imbalanced innate and adaptive responses at the transcriptomic level. Quantification of the expression levels of the genes identified here could contribute to the simultaneous assessment of disease severity and immunological alterations in sepsis.Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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