Academic Journal
Systematic review and meta-analysis of humoral immunity proteins and mortality in sepsis
| Τίτλος: | Systematic review and meta-analysis of humoral immunity proteins and mortality in sepsis |
|---|---|
| Συγγραφείς: | Villa, A, Dewar, F, Pisciotta, W, Rai, A, Kerneis, S, Batum, G, McDonnell, T, Scully, M, McHugh, TD, Hilpert, K, Gilroy, D, de Nooijer, A, Netea, MG, Hedetoft, M, Bermejo-Martin, JF, Akatsuka, M, Heinz, CC, Venet, F, Monneret, G, Meessen, J, Cheng, TH, Zhang, M, Caironi, P, Giamarellos-Bourboulis, EJ, de la Torre Terrón, MC, Ebelt, H, Rademaker, E, Bodelsson, M, Tverring, J, Mi, Y, Knight, JC, Lindsey, ML, Langley, RJ, Kingsmore, SF, Brealey, D, Singer, M, Arulkumaran, N |
| Στοιχεία εκδότη: | Springer Science and Business Media LLC |
| Έτος έκδοσης: | 2026 |
| Συλλογή: | St George's University of London: Repository |
| Περιγραφή: | Purpose Humoral immunity proteins—immunoglobulins, complement proteins, and antimicrobial peptides—have key antimicrobial and immunomodulatory functions in sepsis. We hypothesised that their circulating levels are lower in non-survivors, potentially resulting in impaired bacterial clearance and persistent or recurrent infections. Methods We performed a systematic review and meta-analysis evaluating differences in humoral immunity proteins between survivors and non-survivors in adult patients with sepsis. PubMed and Embase were searched without date restrictions. Random-effects meta-analyses were used to estimate pooled standardised mean differences (SMD) with 95% confidence intervals (CI). Sensitivity analyses included data from the MIMIC-IV ICU database, and further supplemented by three proteomic studies. Results Thirty-six studies including 6,330 patients were analysed. Thirteen reported on immunoglobulins, 17 on complement proteins, and 7 on the antimicrobial peptide heparin-binding protein (HBP). Survivors had significantly higher levels of complement proteins C3 (SMD 0.53 [0.07–0.99]) and C4 (SMD 0.51 [0.09–0.94]) compared to non-survivors. Conversely, C4a (SMD − 1.17 [–1.77 to − 0.56]) and IgA (SMD − 0.21 [–0.39 to − 0.03]) were significantly lower in survivors. No differences were found for IgG (SMD 0.00 [–0.18 to 0.18]), IgM (SMD − 0.02 [–0.13 to 0.08]), C5, C5a, or HBP. Sensitivity analyses using MIMIC-IV (n = 2,452) and proteomic datasets supported these findings. Proteomic data revealed early depletion of classical complement components (C3, C4B) and regulatory proteins in non-survivors. Conclusion Sepsis non-survivors exhibit lower C3 and C4 levels and higher C4a, consistent with complement activation and/or depletion. Complement proteins may serve as potential biomarkers and therapeutic targets in sepsis. |
| Τύπος εγγράφου: | article in journal/newspaper |
| Περιγραφή αρχείου: | application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Γλώσσα: | English |
| ISSN: | 1364-8535 |
| Relation: | https://openaccess.sgul.ac.uk/id/eprint/118227/1/Systemic%20review%20on%20sepsis%202025.pdf; https://openaccess.sgul.ac.uk/id/eprint/118227/3/13054_2025_5758_MOESM1_ESM.docx; Villa, A; Dewar, F; Pisciotta, W; Rai, A; Kerneis, S; Batum, G; McDonnell, T; Scully, M; McHugh, TD; Hilpert, K; et al. Villa, A; Dewar, F; Pisciotta, W; Rai, A; Kerneis, S; Batum, G; McDonnell, T; Scully, M; McHugh, TD; Hilpert, K; Gilroy, D; de Nooijer, A; Netea, MG; Hedetoft, M; Bermejo-Martin, JF; Akatsuka, M; Heinz, CC; Venet, F; Monneret, G; Meessen, J; Cheng, TH; Zhang, M; Caironi, P; Giamarellos-Bourboulis, EJ; de la Torre Terrón, MC; Ebelt, H; Rademaker, E; Bodelsson, M; Tverring, J; Mi, Y; Knight, JC; Lindsey, ML; Langley, RJ; Kingsmore, SF; Brealey, D; Singer, M; Arulkumaran, N (2026) Systematic review and meta-analysis of humoral immunity proteins and mortality in sepsis. Critical Care, 30. p. 41. ISSN 1364-8535 https://doi.org/10.1186/s13054-025-05758-0 SGUL Authors: Hilpert, Kai |
| DOI: | 10.1186/s13054-025-05758-0 |
| Διαθεσιμότητα: | https://openaccess.sgul.ac.uk/id/eprint/118227/ https://openaccess.sgul.ac.uk/id/eprint/118227/1/Systemic%20review%20on%20sepsis%202025.pdf https://openaccess.sgul.ac.uk/id/eprint/118227/3/13054_2025_5758_MOESM1_ESM.docx https://doi.org/10.1186/s13054-025-05758-0 |
| Rights: | cc_by_4 |
| Αριθμός Καταχώρησης: | edsbas.B74622C3 |
| Βάση Δεδομένων: | BASE |
| ISSN: | 13648535 |
|---|---|
| DOI: | 10.1186/s13054-025-05758-0 |