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Clinical value of neutrophil extracellular trap-related biomarkers for sepsis diagnosis and mortality prediction in older patients: A case-control study

Year: 2025

Type: article

Abstract: OBJECTIVES: To assess the clinical utility of neutrophil extracellular trap (NET)-related biomarkers as potential diagnostic and prognostic indicators for sepsis in older patients. METHODS: 39 sepsis older patients (age > 60 years) diagnosed and 28 older patients suffering from infections between August 2024 and April 2025 were enrolled in this study. Peripheral blood plasma was collected to measure NET-related biomarkers, including double-stranded DNA (dsDNA), citrullinated histone H3 (citH3), myeloperoxidase-DNA (MPO-DNA) complex, and nucleosomes. Clinical and laboratory data were extracted from electronic medical records. RESULTS: Patients with sepsis exhibited significantly higher levels of dsDNA, citH3, MPO-DNA, and nucleosomes compared to controls. Non-surviving patients with sepsis had notably elevated dsDNA levels compared to survivors. Correlation analysis revealed a strong positive association between NET-related biomarkers, neutrophil counts, and Sequential Organ Failure Assessment scores. Receiver operating characteristic (ROC) curve analysis indicated that dsDNA was a reliable diagnostic marker for sepsis (area under the curve [AUC] = 0.81, 95% confidence interval [CI], 0.71-0.92, P < 0.001) and mortality prediction (AUC = 0.86, 95% CI, 0.75-0.97, P < 0.001). CONCLUSION: NET-related biomarkers, particularly dsDNA and MPO-DNA, are significantly elevated in sepsis older patients and are independently associated with an increased risk of sepsis.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2025.108299