Martucci Gennaro, Arcadipane Antonio, Tuzzolino Fabio, Occhipinti Giovanna, Panarello Giovanna, Carcione Claudia, Bonicolini Eleonora, Vitiello Chiara, Lorusso Roberto, Conaldi Pier Giulio, Miceli Vitale
Anesthesia and Intensive Care Department, IRCCS-ISMETT, 90133 Palermo, Italy.
Research Department, IRCCS-ISMETT, 90133 Palermo, Italy.
J Pers Med. 2020 Dec 27;11(1):15. doi: 10.3390/jpm11010015.
There is a need to improve acute respiratory distress syndrome (ARDS) diagnosis and management, particularly with extracorporeal membrane oxygenation (ECMO), and different biomarkers have been tested to implement a precision-focused approach. We included ARDS patients on veno-venous (V-V) ECMO in a prospective observational pilot study. Blood samples were obtained before cannulation, and screened for the expression of 754 circulating microRNA (miRNAs) using high-throughput qPCR and hierarchical cluster analysis. The miRNet database was used to predict target genes of deregulated miRNAs, and the DIANA tool was used to identify significant enrichment pathways. A hierarchical cluster of 229 miRNAs (identified after quality control screening) produced a clear separation of 11 patients into two groups: considering the baseline SAPS II, SOFA, and RESP score cluster A ( = 6) showed higher severity compared to cluster B ( = 5); values < 0.05. After analysis of differentially expressed miRNAs between the two clusters, 95 deregulated miRNAs were identified, and reduced to 13 by in silico analysis. These miRNAs target genes implicated in tissue remodeling, immune system, and blood coagulation pathways. The blood levels of 13 miRNAs are altered in severe ARDS. Further investigations will have to match miRNA results with inflammatory biomarkers and clinical data.
有必要改善急性呼吸窘迫综合征（ARDS）的诊断和管理，尤其是在体外膜肺氧合（ECMO）方面，并且已经测试了不同的生物标志物以实施精准聚焦方法。我们将接受静脉-静脉（V-V）ECMO治疗的ARDS患者纳入一项前瞻性观察性试点研究。在插管前采集血样，并使用高通量qPCR和层次聚类分析筛选754种循环微RNA（miRNA）的表达。使用miRNet数据库预测失调miRNA的靶基因，并使用DIANA工具识别显著富集途径。对229种miRNA（经过质量控制筛选后确定）进行层次聚类，将11名患者清晰地分为两组：考虑基线简化急性生理学评分II（SAPS II）、序贯器官衰竭评估（SOFA）和呼吸评分，A组（ = 6）的严重程度高于B组（ = 5）；P值<0.05。对两组之间差异表达的miRNA进行分析后，鉴定出95种失调的miRNA，经计算机分析后减少至13种。这些miRNA的靶基因涉及组织重塑、免疫系统和凝血途径。13种miRNA的血液水平在重度ARDS中发生改变。进一步的研究将不得不将miRNA结果与炎症生物标志物和临床数据相匹配。
