Abstract
BACKGROUND: Sepsis is a life-threatening syndrome caused by an imbalance in the inflammatory response to an infection that can lead to a high mortality rate. Escherichia coli is a common pathogen that causes sepsis. The role of immunoglobulin G N-glycome in estimating the mortality in patients with sepsis remains unknown. This study aims to reveal the clinical application of immunoglobulin G N-glycome as a potentially novel biomarker to predict mortality risk in Escherichia coli-induced sepsis. METHODS: The serum immunoglobulin G N-glycome levels in 100 adult septic patient serum samples on the day of intensive care unit (ICU) admission, and 100 healthy volunteers were measured and analyzed. Immunoglobulin G N-glycome was compared with existing risk scores on predicting in-hospital death. RESULTS: We identified that the fucosylation level was significantly decreased in patients. Importantly, bisecting GlcNAc, sialylation, and galactosylation have different levels between sepsis and control groups. In addition, the AUC values of the SOFA score combined with GP4, GP5, and GP9 were 0.76 (95%CI: 0.61 to 0.90), 0.58 (95%CI: 0.40 to 0.7) and 0.57 (95%CI: 0.38 to 0.76). The AUC value of the SOFA score combined with GP4 and GP7 was 0.85 (95%CI: 0.76 to 0.93) in predicting in-hospital mortality in patients with sepsis. CONCLUSIONS: Immunoglobulin G N-glycome concentrations at ICU admission are valuable for predicting the in-hospital mortality risk of patients with sepsis, suggesting that immunoglobulin G N-glycome may be a novel biomarker.