ORIGINAL RESEARCH article

Front. Med.

Sec. Precision Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1577203

Cell death-related signature genes: risk-predictive biomarkers and potential therapeutic targets in severe sepsis

Provisionally accepted
Yanan  LiYanan LiZengwen  MaZengwen MaYuqiu  TanYuqiu TanWeiwei  QianWeiwei Qian*
  • Emergency Department, Shangjinnanfu Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan, 611730, China, Chengdu, China

The final, formatted version of the article will be published soon.

Sepsis is a systemic inflammatory response syndrome that predisposes to severe lung infections (SeALAR) such as sepsis-associated acute lung injury (Se/ALI) or sepsis-associated acute respiratory distress syndrome (Se/ARDS). Through a systematic bioinformatics approach, this study aimed to unravel the pathogenesis of SeALAR and explore potential biomarkers and individualized therapeutic targets. We analyzed differential genes in the peripheral blood of SeALAR patients based on the GSE10474 and GSE32707 datasets, and identified 352 significantly differentially expressed genes.Various signaling pathways related to immune regulation were found to be significantly altered via GO and KEGG enrichment analysis. Further combining cell death-related gene screening and four machine learning algorithms (including LASSO-logistic, Gradient Boosting Machine, Random Forest and xGBoost), nine SeALAR-characterized cell death genes (SeDGs) were screened and a risk prediction model based on SeDGs was constructed that demonstrated good prediction performance.In immunoassays, ssGSEA showed that Activated.CD8.T.cell, CD56bright.natural.killer.cell, MDSC, Natural.killer.T.cell, T.follicular.helper. cell and TType.1.T.helper.cell had significantly lower infiltration abundance than lower infiltration levels compared to the Se group. GSEA analysis revealed key immune pathways in which SeDGs may be involved. In addition, unsupervised clustering analysis revealed that SeALAR patients could be classified into two molecular subtypes, providing a new direction for the development of individualized immunotherapy strategies. In conclusion, this study systematically analyzed the molecular features and immune disorder mechanism of SeALAR from a multidimensional perspective, and thus provides a theoretical basis and potential targets for precision medicine intervention and targeted drug development.

Keywords: Sepsis, Sepsis-associated acute lung injury or acute respiratory distress syndrome, Cell Death, Signature genes, biomarkers, therapeutic targets

Received: 18 Feb 2025; Accepted: 05 May 2025.

Copyright: © 2025 Li, Ma, Tan and Qian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Weiwei Qian, Emergency Department, Shangjinnanfu Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan, 611730, China, Chengdu, China

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