{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:42:27Z","timestamp":1785426147285,"version":"3.56.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82060378"],"award-info":[{"award-number":["82060378"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,6,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Early identification of patients at risk of developing severe disease remains a clinical challenge for scrub typhus. We aimed to identify serum cytokine profiles associated with disease severity and validate potential biomarkers for early risk stratification of patients with scrub typhus. We conducted a retrospective multicenter study to analyze serum cytokine\/chemokine profiles and clinical data of 51 scrub typhus patients and 13 control patients at presentation to the hospital. We further performed longitudinal monitoring of the cytokine\/chemokine dynamics in 11 of these patients. The findings were then validated in two different hospitals (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 88). Of 44 cytokines\/chemokines tested, 32 were detectable in the serum samples of the patients. Compared with control patients, patients with scrub typhus showed significant elevation of 22 and reductions of 3 cytokines\/chemokines (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). The serum soluble programmed death-ligand 1 (sPD-L1) levels differed significantly across severity groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04) and trended lower during recovery (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.082). sPD-L1 demonstrated a significant trend with increasing severity and showed superior performance to conventional markers in distinguishing patients with organ dysfunction. Receiver operating characteristic analysis of sPD-L1 levels at hospital admission confirmed high discriminatory power, with AUCs of 0.997 and 0.981 in the two validation cohorts. This multicenter study identified sPD-L1 as a potential early biomarker for early risk stratification of patients with scrub typhus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Scrub typhus, caused by\n                      <jats:italic toggle=\"yes\">Orientia tsutsugamushi<\/jats:italic>\n                      , affects over one million people annually in the Asia-Pacific region, with an in-hospital mortality rate of more than 30% among patients with severe disease. Early identification of patients at high risk of progression to multi-organ failure remains a major clinical challenge. Timely risk stratification to identify high-risk patients is essential to prevent poor clinical outcomes. This study identifies soluble programmed death-ligand 1 as a potential early biomarker that distinguishes patients at risk of developing severe disease within the first week of hospitalization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01633-25","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:10:25Z","timestamp":1777281025000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Cytokine and chemokine profiles linked to early severity of scrub typhus: multicenter validation of soluble PD-L1"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4404-7391","authenticated-orcid":true,"given":"Dachuan","family":"Lin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/004eeze55","id-type":"ROR","asserted-by":"publisher"}],"name":"Hainan Medical University-The University of Hong Kong 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