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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.

Sec. Clinical Infectious Diseases

Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1529917

This article is part of the Research Topic Molecular mechanisms and clinical studies of multi-organ dysfunction in sepsis associated with pathogenic microbial infection View all 5 articles

Decoy Receptor 3 as a prognostic biomarker for sepsis and septic shock according to the Sepsis-3 definitions

Provisionally accepted
Long Chen Long Chen 1*Xiao Lin Xiao Lin 2Xing Yu Xing Yu 2Chunxia Yang Chunxia Yang 2Rui Li Rui Li 1Qingqing Guo Qingqing Guo 2Jingshi Shi Jingshi Shi 2Xiuyu Liao Xiuyu Liao 2Xiaoli Chen Xiaoli Chen 2Zengyi Ma Zengyi Ma 1Jiandong Lin Jiandong Lin 2
  • 1 Huashan Hospital, Fudan University, Shanghai, China
  • 2 First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China

The final, formatted version of the article will be published soon.

    ObjectivesThe present study was conducted to reappraise the prognostic value of Decoy Receptor 3 (DcR3) for patients with sepsis and septic shock according to the latest Sepsis-3 definitions.MethodsSubjects suffering from sepsis or septic shock were enrolled within 6 hours of admission. The Sequential Organ Failure Assessment (SOFA) score, and plasma levels of DcR3, C-reactive protein, procalcitonin and interleukin-6 were measured. Group comparisons were made based on the survival status on Day 28 after onset. Predictors of mortality were assessed using the Cox proportional hazard models, and survival curves were plotted with the Kaplan-Meier method. Discriminative performances of single and combined indicators were evaluated via the areas under receiver operating characteristic curves.ResultsAmong 143 eligible sepsis cases, 77 developed septic shock, and the 28-day mortality rates were 32.2% and 45.5%, respectively. Regardless of the population (all sepsis or septic shock), non-survivors exhibited significantly higher DcR3 levels compared to survivors (median 4.19 vs. 2.64 ng/mL, and 4.37 vs. 3.18 ng/mL, respectively; p < 0.001 and p = 0.002, respectively). DcR3 levels were most correlated with organ dysfunction presented by SOFA scores (correlation coefficient = 0.347 and 0.308, respectively; p = 0.001 and 0.016, respectively), but did not differ among the various pathogenic microbes of infection. Multivariate Cox regression identified DcR3 as an independent predictor of mortality (hazard ratio [95% confidence interval] 1.570 [1.048-2.352] and 1.828 [1.047-3.194], respectively; p = 0.029 and 0.034, respectively). Kaplan-Meier analysis showed that elevated DcR3 concentrations were associated with significantly lower survival rates (p = 0.001 and 0.013, respectively). The areas under receiver operating characteristic curves of DcR3 alone for predicting outcome were superior to that of the other three biomarkers (0.731 and 0.711, respectively), and could be further improved when coupled with SOFA scores (0.803 and 0.784, respectively).ConclusionsDcR3 is a valuable prognostic biomarker for sepsis and septic shock, offering the potential to predict 28-day mortality in clinical settings.

    Keywords: biomarker, Decoy receptor 3, Sepsis, septic shock, Organ dysfunction, prognosis

    Received: 18 Nov 2024; Accepted: 12 Feb 2025.

    Copyright: © 2025 Chen, Lin, Yu, Yang, Li, Guo, Shi, Liao, Chen, Ma and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Long Chen, Huashan Hospital, Fudan University, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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