Kim Tae Hoon, Hong Sang-Bum, Lim Chae-Mann, Koh Younsuck, Jang Eun-Young, Huh Jin Won
Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, Korea.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2019 Aug 1;8(8):1148. doi: 10.3390/jcm8081148.
Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by pulmonary and extrapulmonary insults. Exosomes are considered a major cell-to-cell communicator and immune modulator. However, their role in ARDS remains unclear. In this study, we investigated whether exosomes could be a potential biomarker of ARDS.
We isolated exosomes from bronchoalveolar lavage (BAL) of patients with ARDS. The correlation between the level of exosomes with clinical data, including etiology, oxygenation, and 28-day mortality was analyzed. Enzyme-linked immune sorbent assays and western blotting were carried out to characterize BAL exosomes. Immune modulating response of exosomes was investigated by in vitro examination.
From 158 patients, we isolated mean 1568.9 µg/mL BAL exosomes, which presented a negative correlation with the PaO/FiO ratio. The level of exosomes did not correlate with 28-day mortality but was elevated in the infectious etiology of ARDS. The exosomes have cargo proteins associated with apoptosis, necroptosis, and autophagy. An in vitro stimulation study revealed that BAL exosomes could induce the production of proinflammatory cytokines and chemokines, but those from patients with ARDS suppressed the production of vascular endothelial growth factor.
In ARDS, exosomes are released in alveolar space, and the level is correlated with the etiology of ARDS. BAL exosomes could play an immune-modulating role by controlling the production of cytokines.
急性呼吸窘迫综合征（ARDS）是一种由肺部和肺外损伤引起的危及生命的病症。外泌体被认为是细胞间主要的通讯介质和免疫调节剂。然而，它们在ARDS中的作用仍不清楚。在本研究中，我们调查了外泌体是否可能是ARDS的潜在生物标志物。
我们从ARDS患者的支气管肺泡灌洗（BAL）中分离出外泌体。分析了外泌体水平与临床数据（包括病因、氧合和28天死亡率）之间的相关性。进行酶联免疫吸附测定和蛋白质印迹以表征BAL外泌体。通过体外检测研究外泌体的免疫调节反应。
从158例患者中，我们分离出平均1568.9μg/mL的BAL外泌体，其与PaO/FiO比值呈负相关。外泌体水平与28天死亡率无关，但在ARDS的感染性病因中升高。外泌体具有与细胞凋亡、坏死性凋亡和自噬相关的货物蛋白。体外刺激研究表明，BAL外泌体可诱导促炎细胞因子和趋化因子的产生，但ARDS患者的外泌体抑制血管内皮生长因子的产生。
在ARDS中，外泌体在肺泡腔中释放，其水平与ARDS的病因相关。BAL外泌体可通过控制细胞因子的产生发挥免疫调节作用。
