Current sepsis biomarkers may be helpful in determining organ failure and evaluating patient clinical course; however, direct molecular biomarkers to predict subsequent organ failure have not yet been discovered. Exosomes, a small population of extracellular vesicles, play an important role in the inflammatory response, coagulation process and cardiac dysfunction in sepsis. Nonetheless, the association of plasma exosome with severity and mortality of sepsis is not well known. Therefore, the overall levels of plasma exosome in sepsis patients were assessed and whether exosome levels were associated with organ failure and mortality was evaluated in the present study. Plasma level of exosomes was measured by ELISA. Among 220 patients with sepsis, 145 (66%) patients were diagnosed with septic shock. A trend of increased exosome levels in control, sepsis and septic shock groups was observed (204 µg/mL vs 525 µg/mL vs 802 µg/mL, P  < 0.001). A positive linear relationship was observed between overall exosome levels and Sequential Organ Failure Assessment (SOFA) score in the study cohorts (r value = 0.47). When patients were divided into two groups according to best cut‐off level, a statistical difference in 28‐ and 90‐day mortality between patients with high and low plasma exosomes was observed. Elevated levels of plasma exosomes were associated with severity of organ failure and predictive of mortality in critically ill patients with sepsis.

中文翻译：

---

血浆外泌体与脓毒症患者器官衰竭严重程度和死亡率的相关性。

目前的败血症生物标志物可能有助于确定器官衰竭和评估患者的临床病程；然而，尚未发现预测随后器官衰竭的直接分子生物标志物。外泌体是一小群细胞外囊泡，在脓毒症的炎症反应、凝血过程和心脏功能障碍中发挥重要作用。尽管如此，血浆外泌体与脓毒症的严重程度和死亡率的关系尚不清楚。因此，本研究评估了脓毒症患者血浆外泌体的总体水平，并评估了外泌体水平是否与器官衰竭和死亡率相关。通过ELISA测量外泌体的血浆水平。在 220 名脓毒症患者中，145 名 (66%) 患者被诊断为脓毒性休克。外泌体水平升高的趋势得到控制，P  < 0.001)。在研究队列中观察到总体外泌体水平与序贯器官衰竭评估 (SOFA) 评分之间呈正线性关系 ( r值 = 0.47)。当根据最佳临界水平将患者分为两组时，观察到血浆外泌体高和低的患者的 28 天和 90 天死亡率存在统计学差异。血浆外泌体水平升高与器官衰竭的严重程度和脓毒症危重患者的死亡率有关。