Yang Xu-Kai, Wang Nan, Yang Cheng, Wang Yang-Min, Che Tuan-Jie
Department of Urology, Lanzhou General Hospital PLA, Lanzhou 730050, China.
Department of Infection, Xi'an Central Hospital, Xi'an 710033, China.
Chin J Traumatol. 2018 Dec;21(6):316-322. doi: 10.1016/j.cjtee.2018.07.003. Epub 2018 Oct 2.
Urosepsis in adults comprises approximately 25% of all sepsis cases, and is due to complicated urinary tract infections in most cases. However, its mechanism is not fully clarified. Urosepsis is a very complicated disease with no effective strategy for early diagnosis and treatment. This study aimed to identify possible target-related proteins involved in urosepsis using proteomics and establish possible networks using bioinformatics.
Fifty patients admitted to the Urology Unit of Lanzhou General PLA (Lanzhou, China), from October 2012 to October 2015, were enrolled in this study. The patients were further divided into shock and matched-pair non-shock groups. 2-DE technique, mass spectrometry and database search were used to detect differentially expressed proteins in serum from the two groups.
Six proteins were found at higher levels in the shock group compared with non-shock individuals, including serum amyloid A-1 protein (SAA1), apolipoprotein L1 (APOL1), ceruloplasmin (CP), haptoglobin (HP), antithrombin-III (SERPINC1) and prothrombin (F2), while three proteins showed lower levels, including serotransferrin (TF), transthyretin (TTR) and alpha-2-macroglobulin (A2M).
Nine proteins were differentially expressed between uroseptic patients (non-shock groups) and severe uroseptic patients (shock groups), compared with non-shock groups, serum SAA1, APOL1,CP, HP, SERPINC1and F2 at higher levels, while TF, TTR and A2M at lower levels in shock groups.these proteins were mainly involved in platelet activation, signaling and aggregation, acute phase protein pathway, lipid homeostasis, and iron ion transport, deserve further research as potential candidates for early diagnosis and treatment. (The conclusion seems too simple and vague, please re-write it. You may focus at what proteins have been expressed and introduce more detail about its significance.).
成人泌尿系统脓毒症约占所有脓毒症病例的25%，多数情况下由复杂性尿路感染引起。然而，其发病机制尚未完全阐明。泌尿系统脓毒症是一种非常复杂的疾病，目前尚无有效的早期诊断和治疗策略。本研究旨在通过蛋白质组学鉴定参与泌尿系统脓毒症的潜在靶标相关蛋白，并利用生物信息学建立可能的网络。
选取2012年10月至2015年10月在兰州军区兰州总医院泌尿外科住院的50例患者纳入本研究。将患者进一步分为休克组和配对非休克组。采用双向电泳技术、质谱分析和数据库检索来检测两组血清中差异表达的蛋白质。
与非休克个体相比，休克组中有6种蛋白质水平较高，包括血清淀粉样蛋白A-1（SAA1）、载脂蛋白L1（APOL1）、铜蓝蛋白（CP）、触珠蛋白（HP）、抗凝血酶III（SERPINC1）和凝血酶原（F2），而有3种蛋白质水平较低，包括转铁蛋白（TF）、甲状腺素转运蛋白（TTR）和α-2-巨球蛋白（A2M）。
泌尿系统脓毒症患者（非休克组）与严重泌尿系统脓毒症患者（休克组）之间有9种蛋白质差异表达。与非休克组相比，休克组中血清SAA1、APOL1、CP、HP、SERPINC1和F2水平较高，而TF、TTR和A2M水平较低。这些蛋白质主要参与血小板活化、信号传导和聚集、急性期蛋白途径、脂质稳态以及铁离子转运，作为早期诊断和治疗的潜在候选物值得进一步研究。具体而言，血清淀粉样蛋白A-1（SAA1）在炎症反应中发挥着重要作用，其水平升高提示炎症的激活；载脂蛋白L1（APOL1）可能与免疫调节及细胞内信号传导有关，异常表达可能影响机体对感染的免疫反应；铜蓝蛋白（CP）不仅参与铁代谢，还具有抗氧化和调节免疫的功能，其变化可能与脓毒症的病理生理过程密切相关；触珠蛋白（HP）可结合游离血红蛋白，减少其对组织的损伤，在脓毒症时其水平改变反映了机体对溶血等病理状态的应对；抗凝血酶III（SERPINC1）和凝血酶原（F2）在凝血系统中起关键作用，它们的异常表达可能导致凝血功能紊乱，这在脓毒症休克等严重情况下尤为重要；转铁蛋白（TF）负责转运铁离子，其水平降低可能影响铁代谢及相关细胞功能；甲状腺素转运蛋白（TTR）除了运输甲状腺素外，还可能参与其他生理过程，其变化可能与脓毒症时的代谢紊乱有关；α-2-巨球蛋白（A2M）具有广泛的生物学活性，如抑制蛋白酶活性、调节免疫等，其表达改变可能影响脓毒症的进展和转归。深入研究这些蛋白质的作用机制，有助于揭示泌尿系统脓毒症的发病机制，为早期诊断和治疗提供新的靶点和思路。
