Circulating Rather Than Alveolar Extracellular Deoxyribonucleic Acid Levels Predict Outcomes in Influenza
Circulating Rather Than Alveolar Extracellular Deoxyribonucleic Acid Levels Predict Outcomes in Influenza
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循环而非肺泡细胞外脱氧核糖核酸水平可预测流感的结果
DOI：
10.1093/infdis/jiaa241
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Hui Zeng
中科院分区：
文献类型：
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作者：
Nannan Zhang;Liuluan Zhu;Yue Zhang;Chun Zhou;Rui Song;Xiaoyu Yang;Linna Huang;Shuyu Xiong;Xu Huang;Fei Xu;Yajie Wang;Gang Wan;Zhihai Chen;Ang Li;Qingyuan Zhan;Hui Zeng
抽象的。背景高水平的循环中性粒细胞胞外陷阱（NET）与甲型流感感染的预后不良相关。目前尚不清楚血浆或支气管肺泡灌洗液（BALF）中的NET是否可以预测流感的临床结局。方法.招募了2017-2018年诊断为H1N1流感的118例患者。通过定量游离脱氧核糖核酸（cfDNA）和蛋白质-DNA复合物评估血浆和BALF样本中的NET。严重疾病和60天死亡率的预测用受试者工作特征曲线进行分析。结果BALF中NET水平显著升高，并与肺部病理学有关，但与H1N1严重感染患者的疾病严重程度或死亡率无关。重症流感患者的血浆NET水平显著升高，并与氧指数和序贯器官衰竭评估评分呈正相关。高水平的血浆cfDNA（> 286.6ng/mL）或组蛋白结合的DNA（> 9.4ng/mL）区分严重流感与轻度流感，并且甚至更高水平的cfDNA（> 306.3ng/mL）或组蛋白结合的DNA（> 23.1ng/mL）预测重症患者的致命结果。结论.血浆中的cfDNA和组蛋白结合的DNA代表流感预后的早期预测生物标志物。
Abstract. Background. High levels of circulating neutrophil extracellular traps (NETs) are associated with a poor prognosis in influenza A infection. It remains unclear whether NETs in the plasma or bronchoalveolar lavage fluid (BALF) can predict clinical outcomes in influenza.. Methods. One hundred eighteen patients who were diagnosed with H1N1 influenza in 2017–2018 were recruited. The NETs were assessed in plasma and BALF samples by quantifying cell-free deoxyribonucleic acid (cfDNA) and protein-DNA complexes. Predictions of severe illness and 60-day mortality were analyzed with receiver operating characteristic curves.. Results. The NET levels were significantly elevated in the BALF and contributed to the pathology of lungs, yet it was not associated with disease severity or mortality in patients severely infected with H1N1. Plasma NET levels were significantly increased in the patients with severe influenza and positively correlated with the oxygen index and sequential organ failure assessment scores. High levels of plasma cfDNA (>286.6 ng/mL) or histone-bound DNA (>9.4 ng/mL) discriminated severe influenza from mild, and even higher levels of cfDNA (>306.3 ng/mL) or histone-bound DNA (>23.1 ng/mL) predicted fatal outcomes in severely ill patients.. Conclusions. The cfDNA and histone-bound DNA in plasma represent early predictive biomarkers for the prognosis of influenza.