脓毒症患者脂质介质动态变化的病例系列研究。
A case series of the dynamics of lipid mediators in patients with sepsis.
作者信息
Hamaguchi Mitsuhide, Wu Heng Ning, Tanaka Masahiro, Tsuda Noriko, Tantengco Ourlad Alzeus Gaddi, Matsushima Tomohide, Nakao Takami, Ishibe Takuya, Sakata Ikuhiro, Yanagihara Itaru
机构信息
Department of Emergency and Critical Care Medicine Kindai University Faculty of Medicine Osakasayama Osaka Japan.
Department of Developmental Medicine Research Institute Osaka Women's and Children's Hospital Izumi Osaka Japan.
出版信息
Acute Med Surg. 2019 Jul 18;6(4):413-418. doi: 10.1002/ams2.443. eCollection 2019 Oct.
BACKGROUND
Bioactive lipid mediators play a crucial role during infection. Previously, we showed the expression level of mRNA in septic patients was lower than in healthy controls.
CASE PRESENTATION
Four patients with a Sequential Organ Failure Assessment (SOFA) score of <7 recovered from sepsis. One patient with SOFA score of 12 on day 7 died on day 21. In the fatal case, eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, and linoleic acid-derived lipid mediators, including 9-hydroxyoctadecadienoic acid (9-HODE), 13-HODE, 9,10-dihydroxy-12-octadecenoic acid (9,10-DiHOME), and 12,13-DiHOME, were elevated on day 1. Increase in anti-inflammatory prostaglandin E ethanolamide together with persistently lower transcription level of mRNA was detected on day 7 in the fatal case.
CONCLUSION
Lipidomic analysis on day 1 revealed elevated linoleic acid metabolites, whereas on day 7, elevated prostaglandin E ethanolamide and low level of mRNA transcription were observed in the fatal case of sepsis.
背景
生物活性脂质介质在感染过程中起关键作用。此前，我们发现脓毒症患者中mRNA的表达水平低于健康对照者。
病例报告
4例序贯器官衰竭评估（SOFA）评分<7的患者从脓毒症中康复。1例在第7天SOFA评分为12的患者于第21天死亡。在该死亡病例中，二十碳五烯酸、二十二碳六烯酸、花生四烯酸以及亚油酸衍生的脂质介质，包括9-羟基十八碳二烯酸（9-HODE）、13-HODE、9,10-二羟基-12-十八碳烯酸（9,10-DiHOME）和12,13-DiHOME，在第1天升高。在该死亡病例中，第7天检测到抗炎性前列腺素E乙醇酰胺增加以及mRNA转录水平持续降低。
结论
脂质组学分析显示，在脓毒症死亡病例中，第1天亚油酸代谢产物升高，而第7天则观察到前列腺素E乙醇酰胺升高且mRNA转录水平较低。
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