Yoo Hongseok, Lee Jin Young, Park Junseon, Yang Jeong Hoon, Suh Gee Young, Jeon Kyeongman
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
J Clin Med. 2020 Jun 1;9(6):1661. doi: 10.3390/jcm9061661.
Recent studies have suggested that TNF-related apoptosis-inducing ligand (TRAIL) is associated with mortality in sepsis, possibly through necroptosis. The objective of this study was to analyze the association between the plasma level of TRAIL and sepsis severity and outcomes. Furthermore, the plasma level of TRAIL was compared to that of receptor-interacting protein kinase-3 (RIPK3), a key executor of necroptosis, to identify any correlation between TRAIL and necroptosis. Plasma levels of TRAIL and RIPK3 from consecutively enrolled critically ill patients were measured by ELISA. Of 190 study patients, 59 (31.1%) and 84 (44.2%) patients were diagnosed with sepsis and septic shock, respectively. There was a trend of decreased plasma level of TRAIL across the control, sepsis, and septic shock groups. For 143 patients with sepsis, patients with low plasma TRAIL were more likely to have septic shock and higher SAPS3 and SOFA scores. However, no difference in 28-day and 90-day mortalities was observed between the two groups. The plasma level of TRAIL was inversely associated with RIPK3 in patients with sepsis. Plasma levels of TRAIL increased over time on days three and seven, and were inversely associated with sepsis severity and RIPK3 level, but not with mortality.
近期研究表明，肿瘤坏死因子相关凋亡诱导配体（TRAIL）与脓毒症的死亡率相关，可能是通过坏死性凋亡起作用。本研究的目的是分析TRAIL血浆水平与脓毒症严重程度及预后之间的关联。此外，将TRAIL的血浆水平与坏死性凋亡的关键执行者受体相互作用蛋白激酶-3（RIPK3）的血浆水平进行比较，以确定TRAIL与坏死性凋亡之间的任何相关性。通过酶联免疫吸附测定法（ELISA）测量连续纳入的危重症患者的TRAIL和RIPK3血浆水平。在190例研究患者中，分别有59例（31.1%）和84例（44.2%）患者被诊断为脓毒症和脓毒性休克。在对照组、脓毒症组和脓毒性休克组中，TRAIL的血浆水平呈下降趋势。对于143例脓毒症患者，血浆TRAIL水平低的患者更有可能发生脓毒性休克，且序贯器官衰竭评估（SOFA）评分和简化急性生理学评分（SAPS3）更高。然而，两组之间在28天和90天死亡率方面未观察到差异。脓毒症患者中，TRAIL的血浆水平与RIPK3呈负相关。TRAIL的血浆水平在第3天和第7天随时间升高，并与脓毒症严重程度和RIPK3水平呈负相关，但与死亡率无关。
