Urosepsis after upper urinary tract endoscopic
lithotripsy (UUTEL) may cause uroseptic
shock with high mortality, which can be prevented if early diagnosis and timely intervention are implemented with help of a diagnostic
protein panel. The plasma of five rabbits of uroseptic
shock and five controls was subjected to exploratory proteomics to search
biomarker candidates from proteomic profiles related to uroseptic
shock. Then, plasma from 21 nonsepsis and 20 urosepsis patients according to European diagnostic criteria of
sepsis was enrolled in the validation study via targeted proteomics. Changes in a massive number of
plasma proteins, mainly enriched in immune regulation, coagulation, structural repair, and transport activity, were observed in the rabbit model of
septic shock. Fifteen
proteins were identified as differential expression
proteins between
sepsis and nonsepsis patients. A diagnostic model composed of three
proteins lipopolysaccharide-binding protein (LBP),
clusterin (CLU), and vascular cell adhesion
protein 1 (VCAM1) was developed for the early detection (2 hours postoperatively) of urosepsis after UUTEL, with a high area under the receiver operating characteristic (ROC) curve of 0.921. In conclusion, changes in the proteomic profile may reflect the underlying biological mechanisms during the development of urosepsis and produce diagnostic
biomarkers for the early detection of urosepsis after UUTEL.