Szilágyi Bernadett, Fejes Zsolt, Pócsi Marianna, Kappelmayer Janos, Nagy Béla
Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Hungary.
EJIFCC. 2019 Jun 24;30(2):128-145. eCollection 2019 Jun.
Sepsis is a life-threating condition with dysregulated systemic host response to microbial pathogens leading to disproportionate inflammatory response and multi-organ failure. Various biomarkers are available for the diagnosis and prognosis of sepsis; however, these laboratory parameters may show limitations in these severe clinical conditions. MicroRNAs (miRNA) are single-stranded non-coding RNAs with the function of post-transcriptional gene silencing. They normally control numerous intracellular events, such as signaling cascade downstream of Toll-like receptors (TLRs) to avoid excessive inflammation after infection. In contrast, abnormal miRNA expression contributes to the development of sepsis correlating with its clinical features and outcomes. Based on recent clinical studies altered levels of circulating miRNAs can act as potential diagnostic and prognostic biomarkers in sepsis. In this review, we summarized the available data about TLR-mediated inflammatory signaling with its intracellular response in immune cells and platelets upon sepsis, which are, at least in part, under the regulation of miRNAs. Furthermore, the role of circulating miRNAs is also described as potential laboratory biomarkers in sepsis.
脓毒症是一种危及生命的病症，其特征为机体对微生物病原体的全身宿主反应失调，导致过度的炎症反应和多器官功能衰竭。有多种生物标志物可用于脓毒症的诊断和预后评估；然而，这些实验室指标在这些严重临床情况下可能存在局限性。微小RNA（miRNA）是具有转录后基因沉默功能的单链非编码RNA。它们通常控制众多细胞内事件，如Toll样受体（TLR）下游的信号级联反应，以避免感染后发生过度炎症。相反，miRNA表达异常会导致脓毒症的发生，且与临床特征和预后相关。基于近期临床研究，循环miRNA水平的改变可作为脓毒症潜在的诊断和预后生物标志物。在本综述中，我们总结了关于脓毒症时TLR介导的炎症信号及其在免疫细胞和血小板中的细胞内反应的现有数据，这些反应至少部分受miRNA调控。此外，还描述了循环miRNA作为脓毒症潜在实验室生物标志物的作用。
