Wu Xiaoling, Yang Junhui, Yu Li, Long Ding
Intensive Care Unit, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Medicine (Baltimore). 2018 Jul;97(27):e11352. doi: 10.1097/MD.0000000000011352.
The purpose was to evaluate the role of plasma microRNA-223 (miRNA-223) in risk and prognosis in sepsis patients, and its correlation with inflammatory markers.In this study, 187 sepsis patients from July 2015 to December 2016 were consecutively enrolled. Blood samples from septic patients and healthy controls (HCs) were collected, and plasma was separated for miRNA-223 expression detected by quantitative real-time PCR (qPCR). Enzyme-linked immune sorbent assay (ELISA) was performed to detect inflammatory markers.The results were as follows: miRNA-223 was highly expressed in sepsis patients compared to HCs (P < .001). Receiver operating characteristic (ROC) curve revealed miRNA-223 disclosed a good diagnostic value of sepsis with area under curve (AUC) of 0.754, 95% CI: 0.706-0.803. Sensitivity and specificity were 56.6% and 86.6% at the best cut-off point, respectively. Multivariate logistic analysis indicated that miRNA-223 could predict sepsis risk independently. Spearman's correlation disclosed that miRNA-223 relatively expression positively correlated with APCHE II score (r = 0.459, P < 0.001), CRP (r = 0.326, P < 0.001), TNFα (r = 0.325, P < 0.001), IL-1β (r = 0.165, P = 0.024), IL-6 (r = 0.229, P = 0.002) and IL-8 (r = 0.154, P = 0.035), while it was negatively correlated with IL-10 (r = -0.289, P < 0.001). miRNA-223 expression in non-survivor was higher than that in survivor (P < 0.001). ROC curve revealed miRNA-223 could distinguish sepsis non-survivor form survivor with AUC of 0.600, 95% CI: 0.505-0.695. Sensitivity and specificity were 83.5% and 38.9% respectively at the best cut-off point.In conclusion, plasma miRNA-223 correlates with disease severity and inflammatory markers levels, and it might serve as a novel diagnostic and prognostic biomarker in sepsis patients.
本研究旨在评估血浆微小RNA-223（miRNA-223）在脓毒症患者风险及预后中的作用，及其与炎症标志物的相关性。本研究连续纳入了2015年7月至2016年12月期间的187例脓毒症患者。采集脓毒症患者和健康对照者（HCs）的血样，分离血浆，采用定量实时聚合酶链反应（qPCR）检测miRNA-223的表达。采用酶联免疫吸附测定（ELISA）检测炎症标志物。结果如下：与HCs相比，脓毒症患者中miRNA-223高表达（P＜0.001）。受试者工作特征（ROC）曲线显示，miRNA-223对脓毒症具有良好的诊断价值，曲线下面积（AUC）为0.754，95%可信区间（CI）：0.706 - 0.803。在最佳截断点时，敏感度和特异度分别为56.6%和86.6%。多因素逻辑回归分析表明，miRNA-223可独立预测脓毒症风险。Spearman相关性分析显示，miRNA-223相对表达与急性生理与慢性健康状况评分系统II（APCHE II）评分（r = 0.459，P＜0.001）、C反应蛋白（CRP，r = 0.326，P＜0.001）、肿瘤坏死因子α（TNFα，r = 0.325，P＜0.001）、白细胞介素-1β（IL-1β，r = 0.165，P = 0.024）、白细胞介素-6（IL-6，r = 0.229，P = 0.002）和白细胞介素-8（IL-8，r = 0.154，P = 0.035）呈正相关，而与白细胞介素-10（IL-10，r = -0.289，P＜0.001）呈负相关。非存活者中miRNA-223的表达高于存活者（P＜0.001）。ROC曲线显示，miRNA-223能够区分脓毒症非存活者和存活者，AUC为0.600，95%CI：0.505 - 0.695。在最佳截断点时，敏感度和特异度分别为83.5%和38.9%。总之，血浆miRNA-223与疾病严重程度及炎症标志物水平相关，可能作为脓毒症患者一种新的诊断和预后生物标志物。
