MicroRNAs in sepsis: Advances in diagnosis and prognostic monitoring

Table 1 Summary of studies on the diagnostic role of microRNAs in sepsis and septic shock

Ref.	Year	Study type	Up/downregulated	Area under the curve	MicroRNAs	Diagnostic purpose	Sample size
García-Concejo et al[14]	2025	Prospective multicenter observational study	Down	0.960 (validation)	MiR-451a, miR-100-5p, miR-148a-3p	Differentiating septic shock from non-septic shock	161 (109 discovery, 52 validation)
Ye et al[15]	2025	Prospective observational cohort study	Up	0.825 (sepsis), 0.821 (septic shock)	MiR-9-5p	Predicting sepsis and septic shock	134 (69 sepsis, 30 non-sepsis, 35 healthy)
Li et al[13]	2025	Prospective observational study	Down	13.17	MiR-193b-5p	Distinguishing sepsis from healthy conditions	105 (15 exploratory, 90 validation)
Behroozizad et al[16]	2024	Case-control study	Up	1.25	MiR-135a	Independent predictor of sepsis	200 (100 sepsis, 100 healthy)
Li et al[17]	2025	Case-control study	Up	14.39	MiR-181a-5p	Biomarker for sepsis	244 (119 sepsis, 125 healthy)

MiR: MiRNA.

Table 2 Summary of studies on the prognostic and therapeutic monitoring role of microRNAs in sepsis and septic shock

Ref.	Year	Study type	Up/downregulated	AUC/HR/OR	MicroRNAs	Prognostic/therapeutic purpose	Sample size
Wang et al[22]	2024	Retrospective clinical study	Down (post-treatment)	Not specified	MiR-155, miR-146a	Monitoring treatment efficacy (ulinastatin + HBPT)	150 (77 HBPT + ulinastatin, 73 HBPT)
Fan et al[23]	2024	Prospective cohort study	Up (in SAKI)	OR = 1.21	MiR-155	Prognosis of SAKI and 28-day mortality	150 (79 SAKI, 71 septic non-acute kidney injury)
Zhang et al[24]	2025	Prospective cohort study	Up (lower levels = better survival)	AUC = 0.735	MiR-182	Predicting 28-day mortality	178 (128 sepsis, 50 healthy)
Liu et al[25]	2024	Longitudinal study	Fluctuates	AUC = 0.72 (for miR-497)	MiR-195, MiR-497	Guiding timing of immunotherapy/predicting mortality	10 (120 collected samples)
Cheng et al[26]	2025	Prospective single-center cohort study	Down (reduced levels = poor prognosis)	HR = 3.063, AUC = 0.691	MiR-146b-5p	Independent predictor of 28-day mortality	191 septic patients
Mao et al[27]	2023	Observational clinical study	Down (in ALI)	AUC = 0.777	MiR-126-5p	Prognostic factor for sepsis-induced ALI	240 (120 sepsis, 120 healthy)

ALI: Acute lung injury; AUC: Area under the curve; HBPT: Hybrid blood purification treatment; HR: Hazard ratio; MiR: MiRNA; OR: Odds ratio; SAKI: Sepsis-associated acute kidney injury.