Study on the diagnostic role of exosome-derived miRNAs in postoperative septic shock and non-septic shock patients.

Summary

In postsurgical shock, a multicentre prospective study identified and validated a three-miRNA exosomal signature (miR-100-5p, miR-148a-3p, miR-451a) that discriminates septic from non-septic shock with AUC 0.894 in discovery and 0.960 by qPCR in validation.

Key Findings

• Thirty exosome-derived miRNAs differed between septic and non-septic shock in a discovery cohort of 109 patients.
• A three-miRNA panel (miR-100-5p, miR-148a-3p, miR-451a) achieved AUC 0.894 in discovery and 0.960 by qPCR validation in 52 patients.
• Sampling within 24 hours of shock diagnosis supports early diagnostic applicability.

Clinical Implications

A validated three-miRNA signature could be integrated into early postoperative shock workflows to distinguish septic vs non-septic shock and tailor resuscitation and antimicrobial strategies.

Limitations

• Modest sample size and focus on postsurgical ICU patients may limit generalizability
• Clinical utility and turnaround time in routine practice remain to be established

Future Directions

Prospectively test the three-miRNA panel in broader sepsis populations and evaluate clinical decision impact, cost-effectiveness, and integration with existing sepsis bundles.