Organ-targeted Biomarkers of Sepsis: a systematic review reveals the value of inflammation and lipid metabolic dysregulation

Sepsis, a life-threatening systemic inflammatory response to infection, progresses to multiorgan dysfunction involving the heart, lungs, kidneys, brain, and liver. Its heterogeneous pathogenesis involves intertwined pathways such as inflammationmetabolism imbalance, immune dysregulation, mitochondrial dysfunction, and programmed cell death. While traditional biomarkers such as CRP and PCT lack organ-specific sensitivity, emerging multiomics technologies enable systematic network analysis beyond single-molecule detection. Current organ-specific biomarkers focus on four categories: ① inflammatory factors, such as interleukin-6 and high-mobility group protein B1; ② lipid metabolism molecules, such as fatty acid-binding proteins; ③ functional enzymes, such as cholinesterase and NADPH oxidase 4; and ④ noncoding RNAs, such as miR-155 and lncRNA NEAT1, that regulate epigenetic mechanisms. This study systematically reviews the characteristics of biomarkers of organs affected by sepsis reported over the past decade, focuses on analyzing their clinical transformation potential and limitations, and explores the development strategy of multidimensional biomarkers on the basis of the organ interaction network.