Department of Intensive Care Unit, Sir Run Run Shaw Hospital, Medicine School of Zhejiang University, Hangzhou, China.
Bosn J Basic Med Sci. 2019 Aug 20;19(3):249-256. doi: 10.17305/bjbms.2019.4131.
Septic patients suffer a 'cytokine storm' from proinflammatory cytokines, chemokines and other inflammatory mediators, resulting in acute kidney injury (AKI) and death. The purpose of the present study was to determine the expression patterns of microRNA-210 (miR-210), miR-494, and miR-205 in middle-aged and old patients with sepsis-induced AKI and to evaluate their association with patient prognosis. Serum blood urea nitrogen (BUN), creatinine (Cr) and cystatin C levels were determined in peripheral venous blood collected from 110 patients with sepsis-induced AKI and 110 healthy controls. The expression profile of 30 miRNAs was analyzed by TaqMan low-density array (TLDA) in plasma samples from patients and controls. Association of miRNAs with prognosis and survival of patients was analyzed by Spearman's rank correlation coefficient, Cox multivariate analysis, and ROC curve analysis. TILDA analysis showed 11 upregulated and 11 downregulated miRNAs in patients with sepsis-induced AKI. MiR-210 and miR-494 were the most upregulated and miR-205 was the most downregulated miRNA. High expression of miR-210 and miR-494 was positively correlated with BUN, Cr and cystatin C levels of patients, while low expression of miR-205 was negatively correlated. MiR-210 and miR-494 expression was significantly decreased and miR-205 expression was increased in survivors with sepsis-induced AKI (28-day survival, n = 68) vs. non-survivors (n = 42). BUN, Cr, and miR-205 were independent risk factors for prognosis in sepsis-induced AKI. Our study showed the predictive value of miR-210, miR-494, and miR-205 in prognosis and survival of patients with sepsis-induced AKI. MiR-205 is an independent risk factor for sepsis-induced AKI and its decreased expression is associated with shorter patient survival.
脓毒症患者会遭受促炎细胞因子、趋化因子和其他炎症介质引起的“细胞因子风暴”，导致急性肾损伤（AKI）和死亡。本研究旨在确定中老年人脓毒症诱导的 AKI 患者中 microRNA-210 (miR-210)、miR-494 和 miR-205 的表达模式，并评估它们与患者预后的关系。采集 110 例脓毒症诱导 AKI 患者和 110 例健康对照者外周静脉血，检测血清血尿素氮（BUN）、肌酐（Cr）和胱抑素 C 水平。采用 TaqMan 低密度阵列（TLDA）分析患者和对照者血浆样本中的 30 种 miRNA 的表达谱。采用 Spearman 秩相关系数、Cox 多因素分析和 ROC 曲线分析 miRNA 与患者预后和生存的关系。TILDA 分析显示，脓毒症诱导 AKI 患者有 11 种上调和 11 种下调 miRNA。miR-210 和 miR-494 表达上调最显著，miR-205 表达下调最显著。miR-210 和 miR-494 的高表达与患者 BUN、Cr 和胱抑素 C 水平呈正相关，而 miR-205 的低表达与 BUN、Cr 和胱抑素 C 水平呈负相关。脓毒症诱导 AKI 存活者（28 天存活，n = 68）与非存活者（n = 42）相比，miR-210 和 miR-494 表达明显降低，miR-205 表达升高。BUN、Cr 和 miR-205 是脓毒症诱导 AKI 预后的独立危险因素。本研究表明，miR-210、miR-494 和 miR-205 对脓毒症诱导 AKI 患者的预后和生存具有预测价值。miR-205 是脓毒症诱导 AKI 的独立危险因素，其表达降低与患者生存时间缩短有关。
