Cui Yao-Li, Wang Bing, Gao Hong-Mei, Xing Ying-Hong, Li Jian, Li Hong-Jie, Lin Zhu, Wang Yong-Qiang
Department of Lymphoma and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People's Republic of China; Department of Intensive Care Unit and Key Lab for Critical Care Medicine of the Ministry of Health, Emergency Medicine Research Institute, Tianjin First Center Hospital, Tianjin, People's Republic of China.
Department of Intensive Care Unit and Key Lab for Critical Care Medicine of the Ministry of Health, Emergency Medicine Research Institute, Tianjin First Center Hospital, Tianjin, People's Republic of China.
Patient Prefer Adherence. 2016 Mar 11;10:313-9. doi: 10.2147/PPA.S95588. eCollection 2016.
Thrombocytopenia is one of the most common laboratory abnormalities encountered in patients with severe sepsis. It has been reported that thrombocytopenia is linked to mortality in patients with severe sepsis. However, the mechanism of thrombocytopenia in sepsis is unknown. We hypothesized that inflammatory cytokines and microRNAs (miRNAs) are not only involved in the pathogenesis of sepsis, but also are correlated with thrombocytopenia.
Eligible patients with severe sepsis were prospectively recruited and treated at our hospital between June 2012 and May 2014. The miRNA and protein expression of interleukin (IL)-18 and IL-27 were detected by real-time polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. The expression of miR-130a and miR-150 was detected by TaqMan real-time polymerase chain reaction.
Sixty eligible patients were divided into two groups: 28 severe sepsis patients with thrombocytopenia and 32 severe sepsis patients without thrombocytopenia. The results demonstrated that the miRNA expression and plasma concentration of IL-18 in severe sepsis patients with thrombocytopenia were higher than those in severe sepsis patients without thrombocytopenia (P=0.015 and P=0.034, respectively), and miR-130a expression was significantly lower in severe sepsis patients with thrombocytopenia (P<0.003).
Our data demonstrate that severe sepsis patients with thrombocytopenia have increased plasma and miRNA expression levels of IL-18 and decreased expression of miR-130a, suggesting that IL-18 and miR-130a might be involved in the pathophysiological process of severe sepsis with thrombocytopenia.
血小板减少症是重症脓毒症患者最常见的实验室异常之一。据报道，血小板减少症与重症脓毒症患者的死亡率相关。然而，脓毒症中血小板减少症的机制尚不清楚。我们推测炎性细胞因子和微小RNA（miRNA）不仅参与脓毒症的发病机制，还与血小板减少症相关。
2012年6月至2014年5月期间，在我院前瞻性招募并治疗符合条件的重症脓毒症患者。分别通过实时聚合酶链反应和酶联免疫吸附测定法检测白细胞介素（IL）-18和IL-27的miRNA和蛋白表达。通过TaqMan实时聚合酶链反应检测miR-130a和miR-150的表达。
60例符合条件的患者分为两组：28例伴有血小板减少症的重症脓毒症患者和32例不伴有血小板减少症的重症脓毒症患者。结果表明，伴有血小板减少症的重症脓毒症患者的miRNA表达和IL-18血浆浓度高于不伴有血小板减少症的重症脓毒症患者（分别为P = 0.015和P = 0.034），且伴有血小板减少症的重症脓毒症患者中miR-130a表达显著降低（P < 0.003）。
我们的数据表明，伴有血小板减少症的重症脓毒症患者的IL-18血浆和miRNA表达水平升高，miR-130a表达降低，提示IL-18和miR-130a可能参与伴有血小板减少症的重症脓毒症的病理生理过程。
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