• Xiao-Wei Liu, Tao Ma, Wei Liu, Quan Cai, Li Wang, Hong-Wei Song, Liao Yuan, and Zhi Liu.
• Department of Emergency, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
• J Crit Care. 2018 Jun 1; 45: 14-19.

PurposeThe identification of infection at its early stage in vulnerable patients is challenging. This study aimed to investigate potential biomarkers to distinguish patients progressing to severe sepsis from those with uncomplicated sepsis.Materials And MethodsSerum samples were collected from sepsis patients admitted to the emergency department. The mRNA and protein levels of angiopoietin-2 (Ang-2), interleukin-10 (IL-10), heparin-binding protein (HBP), procalcitonin (PCT), adrenomedullin (ADM), and interleukin-6 (IL-6) were evaluated.ResultsCompared to those of healthy individuals (n = 47), mRNA levels of ANG2, IL10, HBP, PCT, and ADM were increased in patients who eventually developed sepsis. ANG2 was the only gene whose expression was significantly increased in patients developing severe sepsis than in those with uncomplicated sepsis. Serum levels of Ang-2, IL-10, HBP, PCT, and IL-6 were also increased in sepsis patients, but only Ang-2, HBP, and PCT were elevated in the serum of patients developing severe septic shock than in those with uncomplicated sepsis. Serum levels of Ang-2, HBP, and PCT were closely associated with the sequential organ failure assessment (SOFA) score of the patients.ConclusionsThese findings indicated that sustained elevation of Ang-2, HBP, and PCT were associated with severe infection in critically ill patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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