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RESEARCH PRODUCT

Circulating Histones and Nucleosomes as Biomarkers in Sepsis and Septic Shock

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Sepsis, severe sepsis, and septic shock are among the leading causes of death worldwide and their incidence is constantly increasing. Despite early intervention in intensive care units (ICUs) mortality remains high. There is great interest in understanding the genetics and epigenetics of the host in response to infection because of two reasons: the peculiarities of each patient, and the unclear associations identified between genetic polymorphisms and susceptibility to sepsis. In addition, chromatin remodeling and epigenetic changes occur in crucial genes involved in the inflammatory response and also in the immunosuppression found in sepsis. The early and accurate diagnosis of sepsis is a challenge at ICUs and therefore there is a clear necessity for proper biomarkers. Over the last few years, circulating histones and nucleosomes have become promising biomarker candidates for the diagnosis and prognosis of these syndromes. The potential of circulating histones and nucleosomes to act as biomarkers in the diagnosis and prognosis of sepsis is emphasized in this chapter. Furthermore, we reflect about the issues yet to be solved for the adoption of these biomarkers in the regular clinical practice.