by Qian He, Xu Huang Background Sepsis-induced immunosuppression is a key factor contributing to high mortality rates. However, suitable biomarkers for routine clinical monitoring of immune function are currently lacking.
Serum cholinesterase levels are markedly diminished in sepsis and are associated with unfavorable prognoses, its role in the immunosuppression pathology and the mechanisms involved remain inadequately understood. Methods We conducted a translational study integrating clinical research, bioinformatics analysis and animal experiments.
Initially, within a single-center clinical cohort, we investigated the correlation between serum cholinesterase levels and lymphocyte subsets in patients suffering from sepsis, subsequently evaluating its association with disease severity (APACHE-II and SOFA scores) and clinical outcomes. Subsequently, by integrating sepsis transcriptome data with cholinergic anti-inflammatory pathways and immune-related gene sets, we identified the hub gene RORA and validated it across multiple dimensions using public databases.
Finally, in the CLP sepsis mouse model, we measured cholinesterase activity and specifically quantified RORA mRNA expression in the spleen. We then analyzed the correlation between these measurements and changes in key immune cell counts.
PLOS ONE (Medicine) published a clinical update in Research Highlights on 07 May 2026.
The item focuses on Serum cholinesterase as a biomarker for sepsis-associated immunosuppression via Hub gene RORA.
Review the original article for the full source wording and details.