{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:20:09Z","timestamp":1792167609060,"version":"4.4.0"},"reference-count":43,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation","doi-asserted-by":"publisher","award":["RS-2023-00208807"],"award-info":[{"award-number":["RS-2023-00208807"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation","doi-asserted-by":"publisher","award":["2020R1C1C1010362"],"award-info":[{"award-number":["2020R1C1C1010362"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation","doi-asserted-by":"publisher","award":["2020R1F1A1071620"],"award-info":[{"award-number":["2020R1F1A1071620"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Korea University Ansan Hospital","award":["K2211961"],"award-info":[{"award-number":["K2211961"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: This study investigated clinical value of galectin-9 (Gal-9), a soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and soluble CD25 (sCD25) among critically ill patients with organ failure in the emergency department. Methods: Overall, 786 patients were enrolled and classified into non-infectious organ failure (NIOF, n = 331), sepsis (n = 266), and septic shock (n = 189). The diagnostic value of Gal-9, sTREM-1, and sCD25 were evaluated by receiver operating characteristic curve analysis. The prognostic value of the biomarkers was evaluated using Kaplan\u2013Meier survival curve and Cox proportional hazard model analyses. Results: Gal-9, sTREM-1, and sCD25 could discriminate sepsis from NIOF (Gal-9, area under the curve [AUC], 0.599\u20130.678; sTREM-1, AUC, 0.616\u20130.695; sCD25, AUC, 0.710\u20130.781) and septic shock from sepsis (Gal-9, AUC, 0.562\u20130.667; sTREM-1, AUC, 0.572\u20130.676; sCD25, AUC, 0.555\u20130.660), respectively. Sepsis patients with higher levels of biomarkers over their cut-off value showed higher 30-day mortality compared to those with lower levels below the cut-off value (Gal-9 \u2265 14,391.80 ng\/L, p &lt; 0.001; sTREM-1 \u2265 580.62 ng\/L, p &lt; 0.001; sCD25 \u2265 1639.29 ng\/L, p &lt; 0.001; respectively) (log-rank test). sCD25 is an independent risk factor for 30-day mortality in patients with sepsis or septic shock. Conclusions: Gal-9, sTREM-1, and sCD25 showed diagnostic and prognostic value in critically ill patients with organ failure. sCD25 can predict the 30-day mortality in patients with sepsis. Gal-9, sTREM-1, and sCD25 could serve as auxiliary biomarkers to support clinicians in effective sepsis management.<\/jats:p>","DOI":"10.3390\/diagnostics15212677","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T01:35:11Z","timestamp":1761269711000},"page":"2677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Value of Galectin-9, Soluble TREM-1, and Soluble CD25 Among Critically Ill Patients with Organ Failure in the Emergency Department: A Prospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3254-5754","authenticated-orcid":false,"given":"Uihwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9556-0665","authenticated-orcid":false,"given":"Sijin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0205-1269","authenticated-orcid":false,"given":"Kap Su","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3769-9647","authenticated-orcid":false,"given":"Su Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-0258","authenticated-orcid":false,"given":"Sungwoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si 15355, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-7360","authenticated-orcid":false,"given":"Juhyun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/s13054-020-02993-5","article-title":"Biomarkers of sepsis: Time for a reappraisal","volume":"24","author":"Pierrakos","year":"2020","journal-title":"Crit. Care"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lee, S., Song, J., Park, D.W., Seok, H., Ahn, S., Kim, J., Park, J., Cho, H.J., and Moon, S. (2022). Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: A prospective observational study according to the Sepsis-3 definitions. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-021-07012-8"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1186\/s13054-020-03351-1","article-title":"Circulating bioactive adrenomedullin as a marker of sepsis, septic shock and critical illness","volume":"24","author":"Lundberg","year":"2020","journal-title":"Crit. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.5005\/jp-journals-10071-23558","article-title":"Neutrophil CD64 a Diagnostic and Prognostic Marker of Sepsis in Adult Critically Ill Patients: A Brief Review","volume":"24","author":"Patnaik","year":"2020","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Song, J., Park, D.W., Moon, S., Cho, H.J., Park, J.H., Seok, H., and Choi, W.S. (2019). Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: A prospective controlled study according to the Sepsis-3 definitions. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4618-7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104287","DOI":"10.1016\/j.cellimm.2021.104287","article-title":"Galectin-9 as a biomarker of disease severity","volume":"361","author":"Moar","year":"2021","journal-title":"Cell. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chagan-Yasutan, H., Hanan, F., Niki, T., Bai, G., Ashino, Y., Egawa, S., Telan, E.F.O., and Hattori, T. (2020). Plasma Osteopontin Levels is Associated with Biochemical Markers of Kidney Injury in Patients with Leptospirosis. Diagnostics, 10.","DOI":"10.3390\/diagnostics10070439"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jcv.2013.10.022","article-title":"Galectin-9 plasma levels reflect adverse hematological and immunological features in acute dengue virus infection","volume":"58","author":"Ndhlovu","year":"2013","journal-title":"J. Clin. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1186\/s12936-016-1471-7","article-title":"Plasma levels of Galectin-9 reflect disease severity in malaria infection","volume":"15","author":"Dembele","year":"2016","journal-title":"Malar. J."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Padilla, S.T., Niki, T., Furushima, D., Bai, G., Chagan-Yasutan, H., Telan, E.F., Tactacan-Abrenica, R.J., Maeda, Y., Solante, R., and Hattori, T. (2020). Plasma Levels of a Cleaved Form of Galectin-9 Are the Most Sensitive Biomarkers of Acquired Immune Deficiency Syndrome and Tuberculosis Coinfection. Biomolecules, 10.","DOI":"10.3390\/biom10111495"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4991","DOI":"10.4049\/jimmunol.164.10.4991","article-title":"Cutting edge: Inflammatory responses can be triggered by TREM-1, a novel receptor expressed on neutrophils and monocytes","volume":"164","author":"Bouchon","year":"2000","journal-title":"J. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S0140-6736(01)06007-X","article-title":"TREM-1 in sepsis","volume":"358","author":"Cohen","year":"2001","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s12098-020-03355-3","article-title":"Surface TREM-1 as a Prognostic Biomarker in Pediatric Sepsis","volume":"88","author":"Kamit","year":"2021","journal-title":"Indian J. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00005-017-0499-x","article-title":"Soluble TREM-1 Serum Level can Early Predict Mortality of Patients with Sepsis, Severe Sepsis and Septic Shock","volume":"66","author":"Jedynak","year":"2018","journal-title":"Arch. Immunol. Ther. Exp."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e010314","DOI":"10.1136\/bmjopen-2015-010314","article-title":"Role of sTREM-1 in predicting mortality of infection: A systematic review and meta-analysis","volume":"6","author":"Su","year":"2016","journal-title":"BMJ Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1515\/cclm-2022-0068","article-title":"Prognostic significance of soluble CD25 in patients with sepsis: A prospective observational study","volume":"60","author":"Huang","year":"2022","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1111\/nep.12230","article-title":"Soluble CD25 is increased in patients with sepsis-induced acute kidney injury","volume":"19","author":"Cho","year":"2014","journal-title":"Nephrology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.talanta.2018.08.058","article-title":"Combined CD25, CD64, and CD69 biomarker panel for flow cytometry diagnosis of sepsis","volume":"191","author":"Zhou","year":"2019","journal-title":"Talanta"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1093\/rheumatology\/kead222","article-title":"Serum level of galectin-9 as a potential biomarker for high risk of malignancy in dermatomyositis","volume":"63","author":"Shih","year":"2024","journal-title":"Rheumatology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5846","DOI":"10.62347\/KELZ4296","article-title":"Correlation of serum H-FABP, sTREM-1, and HMGB1 levels with severity and prognosis of sepsis","volume":"16","author":"Jiang","year":"2024","journal-title":"Am. J. Transl. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102684","DOI":"10.1016\/j.jiac.2025.102684","article-title":"Diagnostic value of sTREM-1, sCD25, sCD40L and sCD130 in late-onset neonatal sepsis","volume":"31","author":"Duan","year":"2025","journal-title":"J. Infect. Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1515\/cclm-2023-0086","article-title":"Why C-reactive protein is one of the most requested tests in clinical laboratories?","volume":"61","author":"Plebani","year":"2023","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1097\/01.CCM.0000063440.19188.ED","article-title":"Comparison of procalcitonin and C-reactive protein as markers of sepsis","volume":"31","author":"Luzzani","year":"2003","journal-title":"Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1172\/JCI200318921","article-title":"C-reactive protein: A critical update","volume":"111","author":"Pepys","year":"2003","journal-title":"J. Clin. Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5852","DOI":"10.1002\/jcb.27870","article-title":"The diagnostic accuracy of procalcitonin and C-reactive protein for sepsis: A systematic review and meta-analysis","volume":"120","author":"Tan","year":"2019","journal-title":"J. Cell. Biochem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13049-019-0609-3","article-title":"Prognostic accuracy of the serum lactate level, the SOFA score and the qSOFA score for mortality among adults with Sepsis","volume":"27","author":"Liu","year":"2019","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"R284","DOI":"10.1186\/cc13147","article-title":"Galectin-9 prolongs the survival of septic mice by expanding Tim-3-expressing natural killer T cells and PDCA-1+ CD11c+ macrophages","volume":"17","author":"Kadowaki","year":"2013","journal-title":"Crit. Care"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Yu, D., Wang, H., Jin, W., Li, X., Hu, Y., Qin, Y., Kong, D., Li, G., and Ellen, A. (2022). Galectin-9 Mediates the Therapeutic Effect of Mesenchymal Stem Cells on Experimental Endotoxemia. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.700702"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1084\/jem.20100687","article-title":"Tim3 binding to galectin-9 stimulates antimicrobial immunity","volume":"207","author":"Jayaraman","year":"2010","journal-title":"J. Exp. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Yasinska, I.M., Sakhnevych, S.S., Pavlova, L., Teo Hansen Seln\u00f8, A., Teuscher Abeleira, A.M., Benlaouer, O., Gon\u00e7alves Silva, I., Mosimann, M., Varani, L., and Bardelli, M. (2019). The Tim-3-Galectin-9 Pathway and Its Regulatory Mechanisms in Human Breast Cancer. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01594"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4192","DOI":"10.1182\/blood-2011-11-389585","article-title":"Galectin-9 binding to Tim-3 renders activated human CD4+ T cells less susceptible to HIV-1 infection","volume":"119","author":"Elahi","year":"2012","journal-title":"Blood"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Kung, C.T., Su, C.M., Hsiao, S.Y., Chen, F.C., Lai, Y.R., Huang, C.C., and Lu, C.H. (2021). The Prognostic Value of Serum Soluble TREM-1 on Outcome in Adult Patients with Sepsis. Diagnostics, 11.","DOI":"10.3390\/diagnostics11111979"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"713","DOI":"10.5114\/aoms.2018.73090","article-title":"Diagnostic effectiveness of soluble triggering receptor expressed on myeloid cells-1 in sepsis, severe sepsis and septic shock","volume":"15","author":"Jedynak","year":"2019","journal-title":"Arch. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/1354750X.2016.1204005","article-title":"Soluble TREM-1 as a diagnostic and prognostic biomarker in patients with septic shock: An observational clinical study","volume":"22","author":"Brenner","year":"2017","journal-title":"Biomarkers"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Su, L., Han, B., Liu, C., Liang, L., Jiang, Z., Deng, J., Yan, P., Jia, Y., Feng, D., and Xie, L. (2012). Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: A prospective cohort study. BMC Infect. Dis., 12.","DOI":"10.1186\/1471-2334-12-157"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jmii.2016.12.002","article-title":"Identification of a panel of serum protein markers in early stage of sepsis and its validation in a cohort of patients","volume":"51","author":"Azkargorta","year":"2018","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1620\/tjem.216.61","article-title":"Sepsis is characterized by the increases in percentages of circulating CD4+CD25+ regulatory T cells and plasma levels of soluble CD25","volume":"216","author":"Saito","year":"2008","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"R60","DOI":"10.1186\/cc12588","article-title":"Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care","volume":"17","author":"Llewelyn","year":"2013","journal-title":"Crit. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s00068-016-0678-1","article-title":"sTREM-1, sIL-2R\u03b1, and IL-6, but not sCD163, might predict sepsis in polytrauma patients: A prospective cohort study","volume":"43","author":"Oever","year":"2017","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Huang, N., Chen, J., Wei, Y., Liu, Y., Yuan, K., Chen, J., He, M., and Liu, N. (2022). Multi-marker approach using C-reactive protein, procalcitonin, neutrophil CD64 index for the prognosis of sepsis in intensive care unit: A retrospective cohort study. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07650-6"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.2147\/JMDH.S422359","article-title":"The Contribution of Procalcitonin, C-Reactive Protein and Interleukin-6 in the Diagnosis and Prognosis of Surgical Sepsis: An Observational and Statistical Study","volume":"16","author":"Tocu","year":"2023","journal-title":"J. Multidiscip. Healthc."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2677\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T01:55:54Z","timestamp":1761270954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":43,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15212677"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15212677","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}