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This is where IL-6 plays an important part. As mentioned, IL-6 is a cytokine that functions as a crucial mediator during the acute phase of response to inflammation in sepsis.<ref name="Arti18">Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions. BMC Infectious Diseases, 19(1), 968, 2019, Song, J., Park, D. W., Moon, S., Cho, H.-J., Park, J. H., Seok, H., & Choi, W. S., https://doi.org/10.1186/s12879-019-4618-7 </ref> Research on the clinical value of IL-6 in patients with sepsis and septic shock describes that IL-6 is considered controversial regarding its diagnostic and prognostic values, where meta-analysis of diagnostic value of IL-6 has shown that IL-6 only offers moderate success in differentiating sepsis from non-infectious systemic inflammatory response syndrome (SIRS).<ref name="Arti19">Role of interleukin-6 to differentiate sepsis from non-infectious systemic inflammatory response syndrome. Cytokine, 88, 126–135, 2016, Ma, L., Zhang, H., Yin, Y.-L., Guo, W.-Z., Ma, Y.-Q., Wang, Y.-B., Shu, C., & Dong, L.-Q., https://doi.org/10.1016/j.cyto.2016.08.033 </ref> Hence it is recommended that IL-6 is used as a biomarker to confirm infection rather than differentiate between sepsis and SIRS<ref name="Arti19">Role of interleukin-6 to differentiate sepsis from non-infectious systemic inflammatory response syndrome. Cytokine, 88, 126–135, 2016, Ma, L., Zhang, H., Yin, Y.-L., Guo, W.-Z., Ma, Y.-Q., Wang, Y.-B., Shu, C., & Dong, L.-Q., https://doi.org/10.1016/j.cyto.2016.08.033 </ref>.
== Medical Application & Relevance ==
As mentioned, sepsis causes each year more than 11 million deaths while affecting approximately 50 million people worldwide.<ref name="Arti2">WHO - Health topics - Sepsis, WHO, 2021, https://www.who.int/health-topics/sepsis#tab=tab_1 </ref> Mortality rates from sepsis, according to data from the Surviving Sepsis Campaign 2012, were approximately 41% in Europe versus approximately 28.3% in the United States.<ref name="Arti20">Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study. Critical Care Medicine, 43(1), 3–12, 2015, Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C. A., Beale, R., Osborn, T., Lemeshow, S., Chiche, J.-D., Artigas, A., & Dellinger, R. P., https://doi.org/10.1097/CCM.0000000000000723 </ref> Severe sepsis causes dysfunction of multiple organs with as a consequence a state of chronic critical illness involving severe immune dysfunction and catabolism.<ref name="Arti21">Sepsis: pathophysiology and clinical management. BMJ, 353, i1585, 2016, Gotts, J. E., & Matthay, M. A., https://doi.org/10.1136/bmj.i1585 </ref>
Despite efforts of experimental and clinical research during the last thirty years, the ability to positively influence the course and outcome of the disease continues to be inadequate. Options of successful and specific interventions are limited and often unsuccessful. If sepsis is detected early and has not affected vital organs yet, administration of different antibiotics have shown to increase chances of survival.<ref name="Arti22">Sepsis—Pathophysiology and Therapeutic Concepts. Frontiers in Medicine, 8, 609, 2021, Jarczak, D., Kluge, S., & Nierhaus, A., https://doi.org/10.3389/fmed.2021.628302 </ref><ref name="Arti20">Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study. Critical Care Medicine, 43(1), 3–12, 2015, Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C. A., Beale, R., Osborn, T., Lemeshow, S., Chiche, J.-D., Artigas, A., & Dellinger, R. P., https://doi.org/10.1097/CCM.0000000000000723 </ref>
Furthermore, early symptoms of sepsis are rather generic, e.g. fever, chills, feeling dizzy or nausea, and thus are not often attributed to sepsis in the early stages.<ref name="Arti23">NHS inform Scotland - Sepsis, https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis, 2020 </ref> When sepsis goes undetected for too long, or if effective treatment is withheld, sepsis can rapidly progress to septic shock where risk of mortality increases by 7.6% each hour . Hence, a patient suffering from sepsis must be diagnosed correctly in time to prevent worsening of the disease with death as a potential consequence.<ref name="Arti22">Sepsis—Pathophysiology and Therapeutic Concepts. Frontiers in Medicine, 8, 609, 2021, Jarczak, D., Kluge, S., & Nierhaus, A., https://doi.org/10.3389/fmed.2021.628302 </ref>
Currently, sepsis is diagnosed with standard laboratory techniques, which takes 12-72 hours before results are obtained. These tests are based on blood cultures looking for bacterial or viral infections.<ref name="Arti24">How is sepsis diagnosed and treated?, Centers for Disease Control and Prevention. (n.d.). Retrieved September 28, 2021, from https://www.cdc.gov/sepsis/diagnosis/ </ref> However, research shows that sepsis cannot always be attributed to only the infectious agent and the immune response that follows, but also to more complex and indirect factors such as significant alterations in coagulation, immunosuppression and organ dysfunction.<ref name="Arti13">Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Medicine, 7, 2050312119835043–2050312119835043, 2019, Gyawali, B., Ramakrishna, K., & Dhamoon, A. S., https://doi.org/10.1177/2050312119835043 </ref> Hence, it is often difficult to diagnose sepsis in a patient on time since multiple causes might be at hand. Early diagnosis is therefore key to battle sepsis. With a biosensor that detects IL-6 in the early stages, symptoms can be classified as belonging to sepsis and consequently, the mortality and severity of sepsis can be decreased. Sepsis is treatable if it is identified and treated quickly which in most cases leads to full recovery with no lasting problems<ref name="Arti23">NHS inform Scotland - Sepsis, https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/sepsis, 2020 </ref>.
== References ==
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