Current and Emerging Biomarkers for Sepsis: Diagnostic and Prognostic Tools

Sepsis, a severe systemic inflammatory response to infection, poses a critical challenge in clinical practice due to its high morbidity and mortality rates. Despite advances in understanding sepsis pathophysiology, diagnosing the condition promptly remains challenging. This review explores current and emerging biomarkers used in sepsis diagnosis and management, highlighting their mechanisms, diagnostic performance, and clinical utility. Procalcitonin (PCT) and C-reactive protein (CRP) are among the most established biomarkers. PCT levels correlate with bacterial infection severity, aiding in early sepsis detection, guiding antibiotic therapy, and providing prognostic insights. CRP, though sensitive to inflammation, lacks specificity for bacterial infections, but it complements PCT in enhancing diagnostic accuracy. Additionally, cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-α provide early indicators of sepsis, while IL-10 offers prognostic information on immune response regulation. Novel biomarkers like soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), proadrenomedullin, heparin-binding protein, neutrophil gelatinase-associated lipocalin, and presepsin show potential in early sepsis diagnosis and risk stratification. Emerging biomarkers, including endotoxin activity assay, and TREM-2 promise to further refine sepsis diagnosis and prognosis. These markers, along with advanced technologies like genomics and proteomics, could improve diagnostic specificity and support personalized treatment strategies. By combining multi-biomarker panels with clinical and laboratory data, the review underscores the importance of integrated approaches in sepsis diagnosis and management, fostering better outcomes through precise, timely intervention.