Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University, PR China.
Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, PR China.
Innate Immun. 2020 Aug;26(6):514-527. doi: 10.1177/1753425920926602. Epub 2020 May 26.
This study aimed to investigate the possible relationship between the two biomarkers presepsin and procalcitonin (PCT) and monocyte immune function, and to explore their combination in mortality prediction in the early stage of sepsis. A total of 198 patients with bacterial infection and diagnosed with sepsis and 40 healthy control subjects were included. Blood samples were collected on admission within 24 h. Plasma concentrations of presepsin and PCT were measured. Expression of monocyte surface CD14, programmed cell death receptor ligand-1 (PD-L1) and human leucocyte Ag (HLA)-DR were determined using flow cytometry. Levels of plasma presepsin and PCT were significantly higher under septic conditions, and increased with the progression of sepsis. Monocyte CD14 and HLA-DR expression were decreased, while PD-L1 was overexpressed in sepsis compared to control. Presepsin and PCT concentrations were positively correlated with Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System II score and PD-L1, while they were negatively correlated with CD14 and HLA-DR. Presepsin plus monocyte HLA-DR mean fluorescence intensity had the highest prognostic value over other parameters alone or in combination. Presepsin and PCT had a weak correlation with monocyte dysfunction during early sepsis. The combination of presepsin and monocyte HLA-DR could help improve prognostic value.
本研究旨在探讨两种生物标志物降钙素原（PCT）和前降钙素（PCT）与单核细胞免疫功能之间的可能关系，并探讨它们在脓毒症早期死亡率预测中的联合应用。共纳入 198 例细菌感染并诊断为脓毒症的患者和 40 名健康对照者。入院后 24 h 内采集血样。测量血浆降钙素原和 PCT 浓度。采用流式细胞术测定单核细胞表面 CD14、程序性细胞死亡受体配体-1（PD-L1）和人类白细胞抗原-DR（HLA-DR）的表达。脓毒症条件下血浆降钙素原和 PCT 水平显著升高，并随脓毒症的进展而升高。与对照组相比，脓毒症患者单核细胞 CD14 和 HLA-DR 表达降低，而 PD-L1 表达上调。降钙素原和 PCT 浓度与序贯器官衰竭评估评分、急性生理学和慢性健康评估系统 II 评分和 PD-L1 呈正相关，与 CD14 和 HLA-DR 呈负相关。降钙素原加单核细胞 HLA-DR 平均荧光强度的预测价值高于其他参数单独或联合应用。降钙素原和 PCT 与脓毒症早期单核细胞功能障碍相关性较弱。降钙素原和单核细胞 HLA-DR 的联合应用可能有助于提高预后价值。
