Introduction
Metabolomic studies can be used to stratify patients with systemic inflammatory response syndrome and sepsis. Changes in the concentrations of aromatic microbial metabolites and inflammation biomarkers are considered to identify sepsis as a manifestation of the most severe metabolic dysfunction.
Aim
To evaluate the diagnostic value of inflammation biomarkers and aromatic microbial metabolites in children during the treatment of malignant oncological diseases.
Materials and methods
The study included patients with various malignant oncological diseases (leukemia, lymphoma, nephroblastoma, ependymoma, etc.) without complications (n = 40); patients with inflammatory and infectious complications (n = 31); and, as a control group, healthy children who participated in a routine medical examination (n = 18). In all groups, biomarkers associated with inflammation were determined: C-reactive protein (CRP), procalcitonin (PCT), and presepsin (PSP), as well as aromatic metabolites associated with sepsis: phenyllactic (PhLA), hydroxyphenyllactic (p-HPhLC), and hydroxyphenylacetic (p-HPhA) acids.
Results
Children with malignant oncological diseases had profound metabolic dysfunction compared to healthy children, regardless of the presence of systemic inflammatory response syndrome (SIRS) or sepsis. The sum of sepsis-associated aromatic microbial metabolite concentrations in children was 2.2 (1.5; 2.6) μmol/L in the control group versus 1.5 (1.1; 1.8) μmol/L in cancer patients (p-value=0.001). High diagnostic ability of procalcitonin and presepsin for detecting sepsis was observed: AUROC=0.875, with a cutoff value (Youden index) of 0.913 ng/ml, and AUROC=0.774, with a cutoff value (Youden index) of 526 pg/ml, respectively.
Conclusion
Decreased concentrations of sepsis-associated aromatic microbial metabolites in cancer patients indicate microbiota dysfunction, which may indicate the need for its timely targeted correction. This study also reveals the high diagnostic ability of procalcitonin and presepsin for detecting sepsis.
