Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Institute of Pediatric Critical Care, Shanghai Jiao Tong University, Shanghai, China.
Immun Inflamm Dis. 2021 Jun;9(2):389-397. doi: 10.1002/iid3.399. Epub 2020 Dec 30.
ATP citrate lyase (ACLY) is involved in lipid metabolism and inflammatory response in immune cells. However, the serum level of ACLY and its clinical relevance in sepsis is totally unknown.
We conducted a prospective pilot study in patients with sepsis admitted to pediatric intensive care unit (PICU) from January 2018 to December 2018.
Higher levels of ACLY were detected in sera of pediatric patients with sepsis than that of healthy children. The area under the receiver operating characteristic curve (AUC) of ACLY for diagnosis of sepsis was 0.855 (95% confidence interval [CI]: 0757-0.952), and an AUC of ACLY for predicting PICU mortality was 0.770 (95% CI: 0.626-0.915). ACLY levels ≤21 ng/ml on PICU admission predicted an unfavorable prognosis among patients with sepsis with a sensitivity of 87.5% and a specificity of 67.6%. Moreover, serum ACLY levels were correlated to platelet count, IL-18 levels, and monocyte counts in pediatric patients with sepsis, implying the potential roles of ACLY in immunometabolic regulation in sepsis.
ACLY is firstly identified in sera of patients with sepsis. Serum ACLY level is an additional diagnostic and prognostic biomarker in pediatric patients with sepsis.
三磷酸腺苷柠檬酸裂解酶（ACLY）参与免疫细胞中的脂质代谢和炎症反应。然而，ACLY 的血清水平及其在脓毒症中的临床相关性尚不清楚。
我们对 2018 年 1 月至 2018 年 12 月期间入住儿科重症监护病房（PICU）的脓毒症患儿进行了一项前瞻性试点研究。
脓毒症患儿血清中 ACLY 水平高于健康儿童。ACLY 诊断脓毒症的受试者工作特征曲线（ROC）下面积为 0.855（95%置信区间[CI]：0.757-0.952），ACLY 预测 PICU 死亡率的 AUC 为 0.770（95%CI：0.626-0.915）。PICU 入院时 ACLY 水平≤21ng/ml 预测脓毒症患者预后不良，其敏感性为 87.5%，特异性为 67.6%。此外，脓毒症患儿的血清 ACLY 水平与血小板计数、IL-18 水平和单核细胞计数相关，表明 ACLY 在脓毒症中的免疫代谢调节中具有潜在作用。
ACLY 首次在脓毒症患者的血清中被发现。血清 ACLY 水平是脓毒症患儿的另一个诊断和预后生物标志物。
