血浆微小RNA水平在肺内型和肺外型急性呼吸窘迫综合征患者之间存在差异：一项临床观察性研究。
Plasma microRNAs levels are different between pulmonary and extrapulmonary ARDS patients: a clinical observational study.
作者信息
Zheng Yi, Liu Song-Qiao, Sun Qin, Xie Jian-Feng, Xu Jing-Yuan, Li Qing, Pan Chun, Liu Ling, Huang Ying-Zi
机构信息
Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, No. 87, Dingjiaqiao Road, Gulou District, Nanjing, 210009, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Medical School of Zhejiang University, 79 Qingchun Road, Shangcheng District, Hangzhou, 310003, China.
出版信息
Ann Intensive Care. 2018 Feb 13;8(1):23. doi: 10.1186/s13613-018-0370-1.
BACKGROUND
Mesenchymal stem cells (MSC) obviously alleviate the damage of the structure and function of pulmonary vascular endothelial cells (VEC). The therapeutic effects of MSC are significantly different between pulmonary ARDS (ARDSp) and extrapulmonary ARDS (ARDSexp). MicroRNAs (miRNAs), as important media of MSC regulating VEC, are not studied between ARDSp and ARDSexp. We aimed to explore the plasma levels difference of miRNAs that regulate VEC function and are associated with MSC (MSC-VEC-miRNAs) between ARDSp and ARDSexp patients.
METHODS
MSC-VEC-miRNAs were obtained through reviewing relevant literatures screened in PubMed database. We enrolled 57 ARDS patients within 24 h of admission to the ICU and then collected blood samples, extracted plasma supernatant. Patients' clinical data were collected. Then, plasma expression of MSC-VEC-miRNAs was measured by real-time fluorescence quantitative PCR. Simultaneously, plasma endothelial injury markers VCAM-1, vWF and inflammatory factors TNF-α, IL-10 were detected by ELISA method.
RESULTS
Fourteen miRNAs were picked out after screening. A total of 57 ARDS patients were included in this study, among which 43 cases pertained to ARDSp group and 14 cases pertained to ARDSexp group. Plasma miR-221 and miR-27b levels in ARDSexp group exhibited significantly lower than that in ARDSp group (miR-221, 0.22 [0.12-0.49] vs. 0.57 [0.22-1.57], P = 0.008, miR-27b, 0.34 [0.10-0.46] vs. 0.60 [0.20-1.46], P = 0.025). Plasma vWF concentration in ARDSexp group exhibited significantly lower than that in ARDSp group (0.77 [0.29-1.54] vs. 1.80 [0.95-3.51], P = 0.048). Significant positive correlation was found between miR-221 and vWF in plasma levels (r = 0.688, P = 0.022). Plasma miR-26a and miR-27a levels in non-survival group exhibited significantly lower than that in survival group (miR-26a, 0.17 [0.08-0.20] vs. 0.69 [0.24-2.33] P = 0.018, miR-27a, 0.23 [0.16-0.58] vs. 1.45 [0.38-3.63], P = 0.021) in ARDSp patients.
CONCLUSION
Plasma miR-221, miR-27b and vWF levels in ARDSexp group are significantly lower than that in ARDSp group. Plasma miR-26a and miR-27a levels in non-survival group are significantly lower than that in survival group in ARDSp patients.
背景
间充质干细胞（MSC）能明显减轻肺血管内皮细胞（VEC）的结构和功能损伤。MSC对肺型急性呼吸窘迫综合征（ARDSp）和肺外源性急性呼吸窘迫综合征（ARDSexp）的治疗效果存在显著差异。微小RNA（miRNA）作为MSC调节VEC的重要介质，在ARDSp和ARDSexp之间尚未得到研究。我们旨在探讨ARDSp和ARDSexp患者之间调节VEC功能且与MSC相关的miRNA（MSC-VEC-miRNA）的血浆水平差异。
方法
通过查阅在PubMed数据库中筛选出的相关文献获取MSC-VEC-miRNA。我们纳入了57例入住重症监护病房（ICU）24小时内的ARDS患者，随后采集血样，提取血浆上清液。收集患者的临床资料。然后，通过实时荧光定量PCR检测MSC-VEC-miRNA的血浆表达。同时，采用酶联免疫吸附测定（ELISA）法检测血浆内皮损伤标志物血管细胞黏附分子-1（VCAM-1）、血管性血友病因子（vWF）以及炎症因子肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）。
结果
筛选出14种miRNA。本研究共纳入57例ARDS患者，其中43例属于ARDSp组，14例属于ARDSexp组。ARDSexp组血浆miR-221和miR-27b水平显著低于ARDSp组（miR-221：0.22[0.12 - 0.49]对0.57[0.22 - 1.57]，P = 0.008；miR-27b：0.34[0.10 - 0.46]对0.60[0.20 - 1.46]，P = 0.025）。ARDSexp组血浆vWF浓度显著低于ARDSp组（0.77[0.29 - 1.54]对1.80[0.95 - 3.51]，P = 0.048）。血浆中miR-221与vWF水平呈显著正相关（r = 0.688，P = 0.022）。在ARDSp患者中，非存活组血浆miR-26a和miR-27a水平显著低于存活组（miR-26a：0.17[0.08 - 0.20]对0.69[0.24 - 2.33]，P = 0.018；miR-27a：0.23[0.16 - 0.58]对1.45[0.38 - 3.63]，P = 0.021）。
结论
ARDSexp组血浆miR-221、miR-27b和vWF水平显著低于ARDSp组。ARDSp患者中非存活组血浆miR-26a和miR-27a水平显著低于存活组。
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