Applying Transcriptomics for an Enhanced Clinical Research Framework, Implications for an Improved Research Strategy based on an Omics Approach: A Scoping Review

Abstract Sepsis remains a major global health issue in pediatric and adult populations, largely due to a lack of understanding of its complex pathophysiology. Despite its high mortality rate, there have been few advancements in sepsis-specific therapies over recent decades. The study aimed to investigate the potential benefits of a genome-wide transcriptomic approach to sepsis in pediatric and adult populations in reducing sepsis-related mortality and enhancing sepsis guidelines. The scoping review explored gene expression data pertinent to developing sepsis guidelines related to its definition, classification, disease severity, molecular biomarking, and benchmarking. A system-biology approach using transcriptomics was adopted to enhance the understanding of sepsis at the mRNA gene expression level. The study involved a search of the PubMed database for original research or systematic reviews that involved transcriptomic application in the context of clinical sepsis published over a ten-year period, from 2012-2022. Of the 14,048 studies retrieved, a full-text analysis was performed. Five main concepts emerged: case definition, classification, quantifying severity of sepsis, transcriptomic biomarkers, and benchmarking. Studies were categorized according to these five categories. The results showed evidence of a connection between the transcript and clinical sepsis, demonstrating that transcript-driven sepsis categorization is possible. Integrating transcriptomic data with clinical endpoints holds promise for more precise sepsis treatment. Although further exploration is needed, the methodology shows potential for disease modification.