A new technique for determining cell-free DNA levels and its diagnostic capabilities in patients with septic shock

Introduction . Multiple studies were shown significant role of cell-free DNA (cfDNA) as a marker and mediator of the septic process. Excessive formation of cfDNA is associated with adverse clinical events, which allows to consider this structure as a potential target for therapy. The objective was to study the level of cell-free DNA in patients with septic shock, to evaluate the correlation of the cfDNA level with clinical and laboratory data of patients, and the incidence of acute kidney injury and mortality. Materials and methods . The prospective single-center observational pilot study included 52 patients over 18 years old with septic shock (Sepsis-3 criteria) admitted to the intensive care unit of the Moscow City Clinical Hospital named after S. S. Yudin of the Health Department of Moscow from August 2023 to May 2024. Results . The final number of patients included in the study was n = 52 (64% of men and 36% of women) aged 52.1 ± 17.3 years, with a severity score according to SOFA 10 ± 4 and Apache II 22 ± 7 points, respectively. The concentration of cfDNA was 3041 (876–7815.0) ng/ml. Correlation analysis revealed associations of various directions with clinical and laboratory data, the most significant was a moderately positive correlation with the level of lactate (r xy = 0.49, p < 0.0001) and creatinine (r xy = 0.42, p < 0.002). ROC curve analysis showed an association between the level of cfDNA and 28-day mortality (area under the curve 0.69, AUC 95% confidence interval (CI) (0.54–0.84), p = 0.031; cut off level – 1893 ng/ml; sensitivity – 72.2% and specificity – 62.5%). Conclusion . The study found that cfDNA had diagnostic value in septic shock, and the level of cfDNA correlated with clinical diagnostic data and significant clinical events in patients with septic shock.