Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies

A. Das; G. Ariyakumar; N. Gupta; S. Kamdar; A. Barugahare; D. Deveson-Lucas; S. Gee; K. Costeloe; M. S. Davey; P. Fleming; D. L. Gibbons

doi:10.1038/s41467-023-44387-5

Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies

A. Das^*, G. Ariyakumar, N. Gupta, S. Kamdar, A. Barugahare, D. Deveson-Lucas, S. Gee, K. Costeloe, M. S. Davey, P. Fleming, D. L. Gibbons^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Bacterial infections are a major cause of mortality in preterm babies, yet our understanding of early-life disease-associated immune dysregulation remains limited. Here, we combine multi-parameter flow cytometry, single-cell RNA sequencing and plasma analysis to longitudinally profile blood from very preterm babies (<32 weeks gestation) across episodes of invasive bacterial infection (sepsis). We identify a dynamically changing blood immune signature of sepsis, including lymphopenia, reduced dendritic cell frequencies and myeloid cell HLA-DR expression, which characterizes sepsis even when the common clinical marker of inflammation, C-reactive protein, is not elevated. Furthermore, single-cell RNA sequencing identifies upregulation of amphiregulin in leukocyte populations during sepsis, which we validate as a plasma analyte that correlates with clinical signs of disease, even when C-reactive protein is normal. This study provides insights into immune pathways associated with early-life sepsis and identifies immune analytes as potential diagnostic adjuncts to standard tests to guide targeted antibiotic prescribing.

Original language	English
Article number	388
Journal	Nature Communications
Volume	15
Issue number	1
Early online date	9 Jan 2024
DOIs	https://doi.org/10.1038/s41467-023-44387-5
Publication status	E-pub ahead of print - 9 Jan 2024

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abstract = "Bacterial infections are a major cause of mortality in preterm babies, yet our understanding of early-life disease-associated immune dysregulation remains limited. Here, we combine multi-parameter flow cytometry, single-cell RNA sequencing and plasma analysis to longitudinally profile blood from very preterm babies (<32 weeks gestation) across episodes of invasive bacterial infection (sepsis). We identify a dynamically changing blood immune signature of sepsis, including lymphopenia, reduced dendritic cell frequencies and myeloid cell HLA-DR expression, which characterizes sepsis even when the common clinical marker of inflammation, C-reactive protein, is not elevated. Furthermore, single-cell RNA sequencing identifies upregulation of amphiregulin in leukocyte populations during sepsis, which we validate as a plasma analyte that correlates with clinical signs of disease, even when C-reactive protein is normal. This study provides insights into immune pathways associated with early-life sepsis and identifies immune analytes as potential diagnostic adjuncts to standard tests to guide targeted antibiotic prescribing.",

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AU - Das, A.

AU - Ariyakumar, G.

AU - Gupta, N.

AU - Kamdar, S.

AU - Barugahare, A.

AU - Deveson-Lucas, D.

AU - Gee, S.

AU - Costeloe, K.

AU - Davey, M. S.

AU - Fleming, P.

AU - Gibbons, D. L.

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Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies

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