双链DNA和核小体作为老年COVID-19患者中性粒细胞胞外诱捕网相关生物标志物的预测价值
Predictive Value of dsDNA and Nucleosomes as Neutrophil Extracellular Traps-Related Biomarkers for COVID-19 in Older Patients.
作者信息
Cui Xudong, Li Tiewei, Yang Jingping, Li Xiaojuan, Xuan Pengfei, Wang Hongyan
机构信息
Respiratory and Critical Care Medicine Department, Inner Mongolia Baogang Hospital, Inner Mongolia Medical University, Hohhot, People's Republic of China.
Department of Clinical Laboratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Children's Infection and Immunity, Zhengzhou, People's Republic of China.
出版信息
J Inflamm Res. 2024 Nov 15;17:8831-8838. doi: 10.2147/JIR.S414688. eCollection 2024.
BACKGROUND
Previous studies have demonstrated that neutrophil extracellular traps (NETs) are crucial in infectious diseases. This study aims to evaluate the clinical value of NET-related biomarkers in identifying the risk of COVID-19 and diagnosing the disease.
METHODS
This study involved 32 patients who tested positive for COVID-19 via polymerase chain reaction (PCR) between April and August 2023. During the same period, 30 healthy volunteers were enrolled as a control group. The principal biomarkers related to NETs are citrullinated histone H3 (CitH3), double-stranded DNA (dsDNA), myeloperoxidase-DNA complex (MPO-DNA), and Nucleosome. Elevated levels in two or more of these biomarkers indicate raised NET concentrations. Multivariable logistic regression analysis was employed to assess whether NET-related biomarkers were the independent risk factor of COVID-19. The diagnostic value of NET-related biomarkers in COVID-19 was further evaluated using receiver operating characteristic (ROC) curve analysis. Statistical procedures were executed in SPSS software (version 24.0, USA).
RESULTS
Compared with the control group, patients infected with COVID-19 had higher levels of dsDNA and nucleosomes (P < 0.001). Correlation analysis revealed a positive correlation between dsDNA levels and neutrophil count (r = 0.309, P = 0.015) as well as between nucleosome levels and neutrophil count (r = 0.446, P < 0.001). Further analysis showed that dsDNA and nucleosomes were independent risk factors for COVID-19 infection. ROC curve analysis showed that dsDNA area under the curve (AUC) = 0.777, 95% confidence interval (CI), 0.661-0.893, P < 0.001, and nucleosomes (AUC = 0.884, 95% CI, 0.778-0.991, P < 0.001) had well diagnostic value in the diagnosing COVID-19 infection.
CONCLUSION
NET-related biomarkers, dsDNA and nucleosomes, were independent risk factors of COVID-19 infection and potentially useful biomarkers in diagnosing COVID-19 infection in older patients.
背景
既往研究表明，中性粒细胞胞外陷阱（NETs）在感染性疾病中至关重要。本研究旨在评估NET相关生物标志物在识别新型冠状病毒肺炎（COVID-19）风险及诊断该疾病中的临床价值。
方法
本研究纳入了2023年4月至8月间经聚合酶链反应（PCR）检测确诊为COVID-19的32例患者。同期，招募30名健康志愿者作为对照组。与NETs相关的主要生物标志物包括瓜氨酸化组蛋白H3（CitH3）、双链DNA（dsDNA）、髓过氧化物酶-DNA复合物（MPO-DNA）和核小体。这些生物标志物中两种或更多种水平升高表明NET浓度升高。采用多变量逻辑回归分析评估NET相关生物标志物是否为COVID-19的独立危险因素。使用受试者工作特征（ROC）曲线分析进一步评估NET相关生物标志物在COVID-19中的诊断价值。统计分析在SPSS软件（美国，版本24.0）中进行。
结果
与对照组相比，COVID-19感染患者的dsDNA和核小体水平更高（P < 0.001）。相关性分析显示，dsDNA水平与中性粒细胞计数之间呈正相关（r = 0.309，P = 0.015），核小体水平与中性粒细胞计数之间也呈正相关（r = 0.446，P < 0.001）。进一步分析表明，dsDNA和核小体是COVID-19感染的独立危险因素。ROC曲线分析显示，dsDNA的曲线下面积（AUC）= 0.777，95%置信区间（CI）为0.661 - 0.893，P < 0.001，核小体的AUC = 0.884，95%CI为0.778 - 0.991，P < 0.001，在诊断COVID-19感染方面具有良好的诊断价值。
结论
NET相关生物标志物dsDNA和核小体是COVID-19感染的独立危险因素，在诊断老年患者COVID-19感染中可能是有用的生物标志物。
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