Identification of circulating microvesicle-encapsulated miR-223 as a potential novel biomarker for ARDS.
Identification of circulating microvesicle-encapsulated miR-223 as a potential novel biomarker for ARDS.
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DOI：
10.14814/phy2.15494
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发表时间：
2022-11
影响因子：
2.5
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中科院分区：
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急性呼吸窘迫综合征（ARDS）是一种致命疾病，其严重形式的死亡率接近40%。ARDS的初始阶段导致急性肺损伤（ALI），其特征是严重的炎症反应和肺毛细血管渗漏引起的渗出性肺泡充血。由于缺乏实验室指导的ARDS诊断生物标志物，降低ARDS死亡率的及时治疗受到限制。本研究的目的是评估含有miR - 223 （MV - miR - 223）的循环微泡（MV - miR - 223）在ARDS患者中是否预示着更严重的肺损伤和更糟糕的结局的预后作用。本文将100例参加沙丁胺醇治疗急性肺损伤（ALTA）试验的ARDS患者血浆样本与20例正常人血浆样本进行比较。MV‐miR‐223的量采用绝对实时聚合酶链反应（PCR）和标准曲线进行测定。计算Mann-Whitney - Wilcoxon、Spearman相关、卡方检验和Kaplan-Meier曲线来评估不同的变量和生存率。与正常对照组相比，ARDS患者的血浆MV - miR - 223水平显著升高。在对MV‐miR‐223与30天死亡率相关的受试者操作特征（ROC）分析中，MV‐miR‐223的曲线下面积（AUC）为0.7021，最佳截断值为2.413 pg/ml。MV‐miR‐223高水平患者的30天死亡率高于MV‐miR‐223低水平患者。MV‐miR‐223与无ICU天数、无呼吸机天数和无器官衰竭天数呈负相关。MV - miR - 223水平高的患者30天和90天死亡率较高。MV‐miR‐223与ALTA试验的28天临床结果相关，包括无ICU天数、无呼吸机天数和无器官衰竭天数。因此，循环MV‐miR‐223可能是预测ARDS患者预后和死亡率的潜在生物标志物。
Acute respiratory distress syndrome (ARDS) is a lethal disease with severe forms conferring a mortality rate approaching 40%. The initial phase of ARDS results in acute lung injury (ALI) characterized by a severe inflammatory response and exudative alveolar flooding due to pulmonary capillary leak. Timely therapies to reduce ARDS mortality are limited by the lack of laboratory‐guided diagnostic biomarkers for ARDS. The purpose of this study was to evaluate the prognostic role of circulating microvesicles (MVs)‐containing miR‐223 (MV‐miR‐223) if indicate more severe lung injury and worse outcomes in ARDS patients. Human plasma samples from one hundred ARDS patients enrolled in Albuterol to Treat Acute Lung Injury (ALTA) trial were compared to a control group of twenty normal human plasma specimens. The amount of MV‐miR‐223 was measured using absolute real‐time polymerase chain reaction (PCR) with a standard curve. Mann–Whitney‐Wilcoxon, Spearman correlation, Chi‐squared tests, and Kaplan–Meier curves were computed to assess different variables and survival. Plasma levels of MV‐miR‐223 were significantly higher in ARDS patients compared to normal control subjects. Upon receiver operator characteristic (ROC) analysis of MV‐miR‐223 in relation to 30‐day mortality, MV‐miR‐223 had an area under the curve (AUC) of 0.7021 with an optimal cut‐off value of 2.413 pg/ml. Patients with high MV‐miR‐223 had higher 30‐day mortality than subjects with low MV‐miR‐223 levels. MV‐miR‐223 was negatively correlated with ICU‐free days, ventilator‐free days, and organ failure‐free days. Patients with high MV‐miR‐223 levels had higher 30 and 90‐day mortality. MV‐miR‐223 was associated with 28‐day clinical outcomes of ALTA trial including ICU‐free days, ventilator‐free days, and organ failure‐free days. Thus, circulating MV‐miR‐223 may be a potential biomarker in prognosticating patient‐centered outcomes and predicting mortality in ARDS.