Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil.
Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, UNESP - Univ. Estadual Paulista, Botucatu, Brazil.
J Cell Mol Med. 2018 Oct;22(10):4732-4737. doi: 10.1111/jcmm.13717. Epub 2018 Jul 25.
The objective of our study was to evaluate the association between peptidylarginine deiminase 4 (PAD4) concentration and its polymorphisms with mortality in patients with septic shock. We prospectively evaluated 175 patients aged over 18 years with septic shock upon intensive care unit (ICU) admission. However, 48 patients were excluded. Thus, 127 patients were enrolled in the study. At the time of the patients' enrollment, demographic information was recorded. Blood samples were taken within the first 24 hours of the patient's admission to determine serum PAD4 concentrations and its polymorphism PADI4_89 [rs11203366], PADI4_94 [rs2240340] and PADI4_104 [rs1748033]. The mean age was 63.3 ± 15.2 years, 56.7% were male, PAD4 concentration was 4.62 (2.48-6.20) ng/mL and the ICU mortality rate was 67.7%. The patients who died in the ICU had higher APACHE II and Sequential Organ Failure Assessment (SOFA) scores. In addition, PAD4 concentration was higher in patients who died during ICU stay. However, there were no differences regarding PADI4 polymorphisms and ICU mortality. In the logistic regression models, PAD4 concentrations were associated with ICU mortality when adjusted for APACHE II score and lactate (OR: 1.477; CI 95%: 1.186-1.839; P < .001), and when adjusted for age, gender and APACHE II score (OR: 1.392; CI 95%: 1.145-1.692; P < .001). In conclusion, PAD4 concentration, but not PADI4_89, PADI4_94 and PADI4_104 polymorphisms, is associated with ICU mortality in septic shock patients.
我们的研究目的是评估肽基精氨酸脱亚氨酶 4（PAD4）浓度及其多态性与脓毒性休克患者死亡率之间的关系。我们前瞻性评估了 175 名年龄在 18 岁以上的 ICU 入住的脓毒性休克患者。然而，有 48 名患者被排除在外。因此，共有 127 名患者纳入研究。在患者入组时，记录了人口统计学信息。在患者入院后的 24 小时内采集血样，以确定血清 PAD4 浓度及其多态性 PADI4_89 [rs11203366]、PADI4_94 [rs2240340]和 PADI4_104 [rs1748033]。平均年龄为 63.3±15.2 岁，56.7%为男性，PAD4 浓度为 4.62（2.48-6.20）ng/mL，ICU 死亡率为 67.7%。在 ICU 死亡的患者中，APACHE II 和序贯器官衰竭评估（SOFA）评分较高。此外，在 ICU 住院期间死亡的患者中 PAD4 浓度更高。然而，PADI4 多态性与 ICU 死亡率之间没有差异。在逻辑回归模型中，在校正 APACHE II 评分和乳酸后，PAD4 浓度与 ICU 死亡率相关（OR：1.477；95%CI：1.186-1.839；P<.001），在校正年龄、性别和 APACHE II 评分后，PAD4 浓度与 ICU 死亡率相关（OR：1.392；95%CI：1.145-1.692；P<.001）。总之，在脓毒性休克患者中，PAD4 浓度，而不是 PADI4_89、PADI4_94 和 PADI4_104 多态性，与 ICU 死亡率相关。
