Blood Biomarker and Raman Analysis of Leukocytes in the Multicenter Intelligence Trials: At the Intensive Care Unit (Intelligence-1) and the Emergency Department (Intelligence-2)
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, goes along with a complex and not yet fully understood host response. Despite many different biomarkers, optimal screening tools to identify patients with sepsis are still needed. In a previous, single-center clinical trial with well-defined and well-separated patient cohorts, a new biophotonic marker based on the Raman spectroscopic characterization of leukocytes showed added value to stratify patients and identify infection and sepsis. RESULTS: In the INTELLIGENCE studies, 279 patients from six centers in two countries were analyzed, and the Raman spectra of ~1500 leukocytes per patient were measured within only 1 hour. This marks a huge step from bench to bedside regarding usability and technology readiness level of Raman spectroscopy in multicentre clinical trials. With a discriminatory power comparable to individual conventional biomarkers (C-reactive protein, procalcitonin, interleukin-6, and soluble urokinase-type plasminogen activator receptor), the Raman score of leukocytes could not provide added value to the clinical discrimination of sepsis in the INTELLIGENCE-1 study cohorts of intensive care patients with infections. When translating the classification model from INTELLIGENCE-1 to the heterogeneous patient cohort recruited at the emergency department of the double-blinded INTELLIGENCE-2 trial, the Raman score failed to provide added value. CONCLUSIONS: In theory, Raman assessment of leukocytes might still be a promising tool for sepsis diagnosis and patient stratification, but there is more basic, translational, and clinical research needed to refine its usability and clinical role, probably also taking questions of the pathophysiology of the dysregulated host response for a phenotype stratification into account.
Source: Shock
Authors: Evangelos J. Giamarellos-Bourboulis, Daniel Thomas-Rüddel, Aikaterini Pistiki, Anuradha Ramoji, Oleg Ryabchykov, Kazi Sultana Farhana Azam, Konstantinos Toutouzas, Athanasios Prekates, Stylianos Karatzas, Christos Mathas, Antigone Kotsaki, Stamatios Chalvatzis, Nikolaos Antonakos, Georgia Damoraki, Jan Rüger, Florian Knorr, Natalie Arend, Anja Silge, Iwan Schie, Jesper Eugen-Olsen, Thomas Bocklitz, Michael Bauer, Johannes Winning, Michael Kiehntopf, Jürgen Popp, Frank Bloos, Ute Neugebauer
Institutions: National and Kapodistrian University of Athens, Albert Einstein College of Medicine, Montefiore Medical Center, Jena University Hospital, Center for Sepsis Control and Care, Leibniz Institute of Photonic Technology, Friedrich Schiller University Jena, Tzaneion General Hospital, Hippocration General Hospital, Agia Olga Hospital, Amager Hospital, Copenhagen University Hospital, Gentofte Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414497922