Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
J Burn Care Res. 2021 Sep 30;42(5):925-933. doi: 10.1093/jbcr/irz170.
The clinical value of Decoy receptor 3 (DcR3) in severe burn is investigated. Ten patients with severe burns were monitored for DcR3, PCT, CRP, IL6, SOFA score, white blood cell (WBC), and platelet. The correlations were analyzed. DcR3 increased on day 1. The nonsurvivors had a steady high level of DcR3 while the survivors had a relatively low level of DcR3. The peak magnitude of DcR3 was high in five nonsurvivors and low in five survivors without overlap. Three patients had a continuously increasing DcR3 level and then died. In the other two nonsurvivors, DcR3 reached the peak and then decreased before death. DcR3 correlated well with PCT (ρ = 0.4469, P < .0001), less with CRP, platelet, IL6, SOFA score and WBC (ρ = 0.4369, 0.4078, 0.3995, 0.2631, 0.1504, respectively, all P < .001). To explore the mechanisms, the HaCaT or THP-1 cells were stimulated by the plasma of burn patients, 45°C, LPS or stimulators of TLRs or NOD2 (PGN, CL264, MDP, iE-DAP, Gardiquimod), and their DcR3 was increased, which could be reduced by GDC-0941 or BEZ235 (inhibitors of PI3K and mTOR). The levels of DcR3 appeared to be a useful biomarker for monitoring the clinical severity and a predictor of mortality of severe burns.
研究了诱饵受体 3 (DcR3) 在严重烧伤中的临床价值。监测了 10 名严重烧伤患者的 DcR3、PCT、CRP、IL6、SOFA 评分、白细胞 (WBC) 和血小板。分析了相关性。DcR3 在第 1 天增加。非幸存者的 DcR3 水平持续升高，而幸存者的 DcR3 水平相对较低。5 名非幸存者的 DcR3 峰值幅度较高，5 名幸存者的 DcR3 峰值幅度较低，没有重叠。3 名患者的 DcR3 水平持续升高后死亡。在另外 2 名非幸存者中，DcR3 达到峰值后在死亡前下降。DcR3 与 PCT 相关性良好 (ρ = 0.4469，P <.0001)，与 CRP、血小板、IL6、SOFA 评分和 WBC 的相关性稍差 (ρ = 0.4369，0.4078，0.3995，0.2631，0.1504，均 P <.001)。为了探讨机制，用烧伤患者的血浆、45°C、LPS 或 TLRs 或 NOD2 的激动剂 (PGN、CL264、MDP、iE-DAP、Gardiquimod) 刺激 HaCaT 或 THP-1 细胞，其 DcR3 增加，用 GDC-0941 或 BEZ235 (PI3K 和 mTOR 的抑制剂) 可降低其 DcR3。DcR3 水平似乎是监测严重烧伤临床严重程度和预测死亡率的有用生物标志物。
