Cell-free DNA – a new prognostic marker for the outcome of sepsis?

Sepsis is associated with a high mortality risk, especially when patients have to be treated in the intensive care unit. It is known today that the individual risk of dying from sepsis varies greatly and that personalized therapy is therefore required. Therefore, a repertoire of diagnostic markers and prognostic factors is essential. Additionally, sepsis is frequently associated with acute renal failure, for which no sufficiently specific and sensitive diagnostic markers are yet available.

In a clinical study with 150 sepsis patients and 81 healthy volunteers in the control group, we investigated whether the quantification of cell-free DNA, which is released during cell death, for example, could be a potentially effective prognostic marker in sepsis. Our results showed that the plasma concentration of cell-free DNA was increased during the acute phase of sepsis compared to the control group and that the level of concentration correlated with 28-day mortality after the onset of sepsis. In addition, patients with sepsis-associated acute kidney failure and patients who required renal replacement therapy (dialysis) had higher cell-free DNA concentrations than those without such kidney damage. Overall, our data highlight that quantification of cell-free DNA could contribute  to an improved risk assessment of i) the development of sepsis-associated acute renal failure, ii) the need for renal replacement therapy and iii) 28-day mortality. These findings were recently published in Frontiers in Immunology.

Dennhardt S, Ceanga IA, Baumbach P, Amiratashani M, Kröller S, Coldewey SM. (2024) Cell-free DNA in patients with sepsis: long term trajectory and association with 28-day mortality and sepsis-associated acute kidney injury. Front Immunol. 15:1382003. doi: 10.3389/fimmu.2024.1382003.