MicroRNAs in sepsis diagnosis: A systematic review and meta-analysis toward evidence-based biomarker development.

IF 3.8 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection Pub Date : 2026-06-23 DOI:10.1016/j.jmii.2026.06.004

Shu-Hui Chen, Sameer Noor, Wei-Hsuan Liu, Tzu-Ti Tien, Chin-Chieh Wu, Kuan-Fu Chen

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引用次数: 0

Abstract

Background: Sepsis diagnosis remains challenging, and conventional biomarkers such as CRP and PCT show limited specificity. Circulating microRNAs (miRNAs) have been investigated as diagnostic biomarkers, but substantial methodological variability across studies has limited the interpretation of current evidence. Previous meta-analyses largely evaluated miRNAs as a single biomarker category, leaving variation across biologically distinct subgroups insufficiently explored.

Methods: Following PRISMA 2020 and PRISMA-DTA 2018 guidelines, we systematically searched PubMed, EMBASE, and Scopus through April 2026. Study quality was assessed using QUADAS-2, and pooled diagnostic performance was analyzed using a hierarchical summary receiver operating characteristic (HSROC) model. Subgroup analyses explored clinical, methodological, and functional sources of heterogeneity.

Results: Thirty-nine studies involving 59 distinct miRNAs were included. Pooled sensitivity was 0.79 (95% CI: 0.76-0.82) and specificity was 0.82 (95% CI: 0.78-0.85), with an AUROC of 0.87 (95% CI: 0.84-0.90). Substantial heterogeneity was observed (sensitivity I² = 92.4%; specificity I² = 89.0%). In exploratory functional subgroup analyses, IL-1β-associated miRNAs demonstrated higher overall diagnostic accuracy (AUROC 0.90, 95% CI: 0.87-0.92), while endothelial dysfunction-related miRNAs showed comparatively higher specificity.

Conclusion: Circulating miRNAs demonstrate moderate diagnostic accuracy for sepsis, with functional subgroup analyses showing differences across biologically distinct miRNA categories. Diagnostic performance appears to vary according to both biological function and methodological context. Substantial heterogeneity limits the generalizability of current evidence. Future multicenter studies using standardized protocols and infected non-septic control groups are needed to determine the clinical utility of pathway-specific miRNA panels.

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MicroRNAs在败血症诊断中的应用：循证生物标志物发展的系统回顾和荟萃分析。

背景：脓毒症的诊断仍然具有挑战性，传统的生物标志物如CRP和PCT显示有限的特异性。循环microRNAs （miRNAs）已被研究作为诊断性生物标志物，但研究方法的实质性差异限制了对现有证据的解释。先前的荟萃分析主要将mirna作为单一的生物标志物类别进行评估，而对不同生物亚群之间的差异进行了充分的研究。方法：遵循PRISMA 2020和PRISMA- dta 2018指南，系统检索PubMed、EMBASE和Scopus，截止到2026年4月。使用QUADAS-2评估研究质量，并使用分层汇总受试者工作特征（HSROC）模型分析合并诊断性能。亚组分析探讨了临床、方法学和功能异质性的来源。结果：纳入了39项研究，涉及59种不同的mirna。合并敏感性为0.79 (95% CI: 0.76-0.82)，特异性为0.82 (95% CI: 0.78-0.85)， AUROC为0.87 （95% CI: 0.84-0.90）。观察到大量异质性（敏感性I2 = 92.4%，特异性I2 = 89.0%）。在探索性功能亚组分析中，il -1β相关的mirna表现出更高的总体诊断准确性（AUROC为0.90,95% CI为0.87-0.92），而内皮功能障碍相关的mirna表现出相对更高的特异性。结论：循环miRNA对脓毒症的诊断具有中等准确性，功能亚组分析显示生物学上不同的miRNA类别存在差异。诊断表现似乎根据生物学功能和方法学背景而有所不同。实质性的异质性限制了现有证据的普遍性。未来的多中心研究需要使用标准化的方案和感染的非脓毒症对照组来确定途径特异性miRNA面板的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Microbiology Immunology and Infection IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

15.90

自引率

5.40%

发文量

159

审稿时长

67 days

期刊介绍： Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence. With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.