Research Article
Prognostic Role of Nucleosomes Containing Histones of the H3.1 Type in Septic Shock: Results of a Prospective Study
Issue:
Volume 12, Issue 5, October 2026
Pages:
82-95
Received:
31 May 2026
Accepted:
13 July 2026
Published:
23 October 2026
DOI:
10.11648/j.ijcems.20261205.11
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Abstract: Cell-free DNA (cfDNA) and neutrophil extracellular traps (NETs), specifically marked by histone type 3.1, play a dual pathogenic role in sepsis by reflecting cellular damage and directly exacerbating tissue injury, highlighting their clinical relevance for extracorporeal elimination therapies. To evaluate their prognostic value, we conducted a prospective, single-center observational study quantifying nucleosomes containing histones of the H3.1 type (Nu.H3.1) in 52 adult patients with septic shock admitted to an intensive care unit between August 2023 and May 2024. The cohort (64% male) had a mean SOFA score of 10±4 and an APACHE II score of 22±7. The H3.1-nuc concentration was 4658 ± 3962 ng/mL, and the median cfDNA level was 3041 (876–7815) ng/mL. Statistical analysis revealed that Nu.H3.1 levels significantly and positively correlated with cfDNA (r=0.67; p=0.0001), serum lactate (r=0.4; p=0.004), and SOFA scores (r=0.41; p=0.002). Furthermore, Nu.H3.1 demonstrated significant predictive performance for both 28-day mortality (AUC=0.68; 95% CI: 0.53–0.84; p=0.037) and the development of acute kidney injury (AKI) (AUC=0.74; 95% CI: 0.57–0.90; p=0.014). In conclusion, Nu.H3.1 serves as an independent predictor of adverse outcomes in septic shock, with established threshold values identifying patients at high risk for mortality and AKI. These findings suggest that Nu.H3.1 is a promising biomarker for clinical risk stratification and for substantiating indications for the extracorporeal elimination of toxic DNA-associated structures from the systemic circulation.
Abstract: Cell-free DNA (cfDNA) and neutrophil extracellular traps (NETs), specifically marked by histone type 3.1, play a dual pathogenic role in sepsis by reflecting cellular damage and directly exacerbating tissue injury, highlighting their clinical relevance for extracorporeal elimination therapies. To evaluate their prognostic value, we conducted a pros...
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,
Anastasia Doronenkova
