MicroRNA Biomarkers in Sepsis Management

Sepsis remains a leading cause of mortality in intensive care units worldwide, arising from a dysregulated host response to infection and culminating in organ dysfunction. Conventional biomarkers such as C-reactive protein and procalcitonin offer limited specificity and delayed kinetics. MicroRNAs (miRNAs) are small non-coding RNA molecules that post-transcriptionally regulate gene expression by binding target messenger RNAs. Their stable presence in blood and extracellular vesicles, coupled with disease-specific expression patterns, has positioned them as promising diagnostic and prognostic biomarkers in sepsis. Profiling circulating miRNAs may enable earlier detection of sepsis, differentiation from non-infective inflammatory states and real-time monitoring of therapeutic responses. Advances in high-throughput sequencing and quantitative PCR have facilitated the identification of miRNA signatures linked to immune dysregulation, endothelial injury and organ failure. Despite technical challenges relating to sample standardisation and data interpretation, translational studies continue to explore panels of miRNAs capable of refining risk stratification and guiding personalised interventions in sepsis management.

Research from Nature Portfolio

A seminal study demonstrated that circulating inflammation-related microRNAs (CIR-miRNAs) differentiate sepsis from non-infective systemic inflammatory response syndrome. Using next-generation sequencing and qRT-PCR, researchers profiled over one hundred miRNAs in plasma from critically ill patients and identified six key CIR-miRNAs whose levels inversely correlated with interleukin-1 and interleukin-6. These six miRNAs achieved excellent discrimination between severe sepsis and severe non-infective inflammation, supporting their potential as point-of-care diagnostic markers and illuminating their role in modulating downstream cytokine networks.

MicroRNA Biomarkers in Sepsis Management publication trend

The graph below shows the total number of articles in microrna biomarkers in sepsis management across all publications each year (not limited to Nature Index journals).

Technical terms

MicroRNA (miRNA): A small non-coding RNA of 18–25 nucleotides that regulates gene expression by binding complementary sequences in target mRNAs, leading to translational repression or degradation.

Biomarker: A measurable biological molecule whose presence, absence or concentration correlates with a specific physiological or pathological state, used for diagnosis, prognosis or therapy monitoring.

Extracellular vesicle: Membrane-bound particle released by cells that transports proteins, lipids and nucleic acids (including miRNAs) between cells, facilitating intercellular communication.

Systemic inflammatory response syndrome (SIRS): A clinical syndrome characterised by two or more systemic signs of inflammation, which may be triggered by infective or non-infective insults.

Quantitative PCR (qRT-PCR): A laboratory technique that quantifies nucleic acids through real-time monitoring of amplification, enabling precise measurement of miRNA expression levels.

References

1. Circulating Plasma microRNAs can differentiate Human Sepsis and Systemic Inflammatory Response Syndrome (SIRS). Scientific Reports (2016).
2. Pre-Clinical Studies of MicroRNA-Based Therapies for Sepsis: A Scoping Review. Oxygen (2024).
3. Prognostic implication of downregulated exosomal miRNAs in patients with sepsis: a cross-sectional study with bioinformatics analysis. Journal of Intensive Care (2023).
4. MicroRNA as Sepsis Biomarkers: A Comprehensive Review. International Journal of Molecular Sciences (2024).