Identification of Monocyte CD11c as a Potential Biomarker for Distinguishing Sepsis From Non-Infectious Inflammation and Predicting the Outcome of Sepsis

Limin Kong,1,* Yujun Zhou,1,* Dawei Li,2,* Ning Hua,3 Yanfang Zhang,1 Hangyang Li,4 Peili Ding,4 Yuyu Nan,4 Hua Zhou,5 Ping Yang,1 Wuping Shuai,1 Sheng Zhang,6 Yuanzhi Ju,1 Xiaohui Yang,7 Jiasheng Song,7 Xuesong Liu,2 Wenqiao Yu,4 Saiping Jiang1 1Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, People’s Republic of China; 3Department of Biophysics, and Department of Neurology of The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, People’s Republic of China; 4Department of Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 6Department of Intensive Care Unit, Taizhou Hospital of Zhejiang Province, Taizhou, People’s Republic of China; 7School of Pharmacy, Hangzhou Normal University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenqiao Yu, Department of Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China, Email [email protected] Saiping Jiang, Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China, Email [email protected]: To investigate whether monocyte CD11c (mCD11c) can serve as a promising biomarker for the diagnosis and prognosis of sepsis, distinguishing it from non-infectious inflammatory conditions.Methods: A prospective, observational cohort study was conducted using a discovery cohort (sepsis, mild infection, patients after cardiovascular surgery, recovered sepsis patients, and healthy controls) and a validation cohort (sepsis, mild infection, and patients after cardiovascular surgery). Peripheral blood samples were analyzed using Cytometry by Time-of-Flight (CyTOF), single-cell RNA sequencing, and flow cytometry to assess the immune cell composition and mCD11c expression. Clinical data and outcomes were collected for analysis.Results: The discovery cohort showed a significant downregulation of mCD11c in patients with sepsis. The validation cohort confirmed a lower mCD11c% in sepsis than in the other groups. Receiver operating characteristic (ROC) curve analysis showed that mCD11c had a higher AUC (0.939, P < 0.001) than traditional markers in distinguishing sepsis from non-infectious inflammation. mCD11c% was an independent prognostic factor for 7-day mortality (P < 0.05), with significant differences in survival rates between patients with mCD11c% above and below 96.445%.Conclusion: mCD11c is a promising biomarker for early sepsis diagnosis and short-term survival prediction, outperforming the traditional markers. Larger multicenter studies are needed to validate these findings and to explore their potential as intervention targets.Keywords: sepsis, biomarker, monocyte CD11c, diagnostic value, survival prognosis