Serum NLRP3: A biomarker for identifying high-risk septic patients
Serum NLRP3: A biomarker for identifying high-risk septic patients
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DOI：
10.1016/j.cyto.2021.155725
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发表时间：
2021-10-08
期刊：
影响因子：
3.8
通讯作者：
Liu, Dawei
中科院分区：
文献类型：
--
作者：
Huang, Wei;Wang, Xiaoting;Liu, Dawei
背景：NLRP 3炎性体的过度激活可导致脓毒症。NLRP 3是经典的细胞凋亡途径中的必需蛋白。本研究评估了血清NLRP 3水平作为脓毒症患者中潜在炎症生物标志物的用途。研究方法：患者分为五组：健康对照组（n = 30）、ICU对照组（n = 22）、感染组（n = 19）、脓毒性非休克组（n = 33）和脓毒性休克组（n = 83）。所有患者在入组时通过酶联免疫吸附测定法测定血清NLRP 3水平。还评估了临床参数和实验室检查数据（APACHE II、SOFA和乳酸盐）。此外，通过曲线下面积（AUC）分析确定血清NLRP 3水平预测脓毒症的能力。结果如下：感染性休克组的NLRP 3水平显著高于对照组。（431.89，386.61-460.21 pg/mL）高于健康对照组（23.24，9.38-49.73 pg/mL），ICU对照组（74.82，62.71-85.93 pg/mL），感染组（114.34，99.21-122.56 pg/mL）和脓毒性非休克组（136.99，128.80-146.98 pg/mL;所有比较P< 0.001）。此外，AUC表明血清NLRP 3水平预测脓毒症和脓毒性休克发生率的能力不低于SOFA评分。具有较高NLRP 3血清水平（>147.72 pg/mL）的患者具有显著增加的30天死亡率。结论：NLRP 3可用于早期识别高危脓毒症患者，尤其是脓毒性休克患者。此外，NRLP 3水平升高可能导致脓毒症预测结果较差。
Background: Over-activation of the NLRP3 inflammasome can lead to sepsis. NLRP3 is an essential protein in the classical pathway of pyroptosis. This study assessed the use of serum NLRP3 level as a potential inflammatory biomarker in septic patients. Methods: Patients were categorized into five groups: healthy controls (n = 30), ICU controls (n = 22), infection (n = 19), septic non-shock (n = 33), and septic shock (n = 83). Serum NLRP3 levels were measured by enzymelinked immunosorbent assay for all patients upon enrollment. Clinical parameters and laboratory test data (APACHE II, SOFA, and lactate) were also assessed. Moreover, the ability of serum NLRP3 levels to predict sepsis was determined by the area under the curve (AUC) analysis. Results: The NLRP3 levels in the septic shock group was significantly higher (431.89, 386.61-460.21 pg/mL) than that in the healthy control group (23.24, 9.38-49.73 pg/mL), ICU control group (74.82, 62.71-85.93 pg/mL), infection group (114.34, 99.21-122.56 pg/mL), and septic non-shock group (136.99, 128.80-146.98 pg/mL; P< 0.001 for all comparisons). Additionally, the AUC indicated that the ability of serum NLRP3 levels to predict sepsis and septic shock incidences was not lower than that of the SOFA score. Patients with higher NLRP3 serum levels (>147.72 pg/mL) had significantly increased 30-day mortality rate. Conclusions: NLRP3 is useful for the early identification of high-risk septic patients, particularly septic shock patients. Moreover, elevated NRLP3 levels could result in poor septic prediction outcomes.