Department of Critical Care Medicine, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University (The First People's Hospital of Xuzhou), Xuzhou, Jiangsu Province, 221000, China.
Department of Rheumatology and Immunology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University (The First People's Hospital of Xuzhou), Xuzhou, Jiangsu Province, 221000, China.
BMC Anesthesiol. 2024 Jan 18;24(1):30. doi: 10.1186/s12871-024-02405-z.
The present research aims to investigate the clinical diagnostic value of LncRNA HOXA distal transcript antisense RNA (HOTTIP) in acute respiratory distress syndrome (ARDS) of sepsis and its predictive significance for mortality.
One hundred eighteenth patients with sepsis and 96 healthy individuals were enrolled. RT-qPCR to examine HOTTIP levels. The incidence of ARDS and death was recorded. The diagnostic significance of HOTTIP in sepsis ARDS was examined using ROC and logistic regression analysis. The correlation between HOTTIP and disease severity was evaluated using Pearson's coefficients. Kaplan-Meier analysis and COX regression were employed to examine the predictive significance of mortality. Validation of HOTTIP target miRNA by dual-luciferase assay.
HOTTIP was persistently up-regulated in patients with ARDS sepsis than in patients without ARDS patients (P < 0.05). HOTTIP was a risk factor for the development of ARDS, which could be diagnosed in ARDS patients from non-ARDS patients (AUC = 0.847). Both the SOFA score (r = 0.6793) and the APACHE II score (r = 0.6384) were positively correlated with the HOTTIP levels. Furthermore, serum HOTTIP was an independent predictor of short-term mortality (HR = 4.813. 95%CI: 1.471-15.750, P = 0.009) and noticeably predicted the occurrence of short-term death (log rank = 0.020). miR-574-5p, a target miRNA for HOTTIP, was reduced in patients with sepsis ARDS and negatively correlated with HOTTIP.
The presence of HOTTIP serves as a diagnostic biomarker for the occurrence of ARDS, exhibits correlation with disease severity, and provides predictive value of short-term mortality in sepsis patients. HOTTIP may be involved in ARDS progression by targeting miR-574-5p.
本研究旨在探讨长链非编码 RNA HOXA 远端转录反义 RNA（HOTTIP）在脓毒症急性呼吸窘迫综合征（ARDS）中的临床诊断价值及其对死亡率的预测意义。
纳入 118 例脓毒症患者和 96 名健康对照者。采用 RT-qPCR 检测 HOTTIP 水平。记录 ARDS 的发生率和死亡情况。采用 ROC 和 logistic 回归分析评估 HOTTIP 在脓毒症 ARDS 中的诊断意义。采用 Pearson 系数评估 HOTTIP 与疾病严重程度的相关性。采用 Kaplan-Meier 分析和 COX 回归分析评估死亡率的预测意义。采用双荧光素酶报告基因实验验证 HOTTIP 的靶 miRNA。
ARDS 脓毒症患者的 HOTTIP 持续上调，高于无 ARDS 患者（P<0.05）。HOTTIP 是 ARDS 发生的危险因素，可将 ARDS 患者与非 ARDS 患者区分（AUC=0.847）。SOFA 评分（r=0.6793）和 APACHE II 评分（r=0.6384）均与 HOTTIP 水平呈正相关。此外，血清 HOTTIP 是短期死亡率的独立预测因子（HR=4.813，95%CI：1.471-15.750，P=0.009），并能显著预测短期死亡的发生（log rank=0.020）。脓毒症 ARDS 患者 miR-574-5p 减少，与 HOTTIP 呈负相关。
HOTTIP 的存在可作为 ARDS 发生的诊断生物标志物，与疾病严重程度相关，并对脓毒症患者的短期死亡率具有预测价值。HOTTIP 可能通过靶向 miR-574-5p 参与 ARDS 进展。
