Heme oxygenase-1 as an important predictor of the severity of COVID-19.
Heme oxygenase-1 as an important predictor of the severity of COVID-19.
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DOI：
10.1371/journal.pone.0273500
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
细胞因子风暴由炎性细胞引起，包括促炎巨噬细胞表型（M1），在COVID-19的发病机制中发挥关键作用，其中由于氧化应激暴露，肺中发生弥漫性肺泡损伤。血红素加氧酶（HO）-1是由抗炎/抗氧化巨噬细胞表型（M2）产生的应激诱导蛋白，其还产生可溶性CD 163（sCD 163）。在我们的研究中，我们调查并确定血清HO-1可以作为评估COVID-19患者严重程度和预后的预测性生物标志物。入院时检测COVID-19患者血清HO-1和sCD 163浓度。评价了这些生物标志物与其他临床参数和结局之间的关系。对64名COVID-19患者（11名轻度、38名中度和15名重度病例）进行了评估。血清HO-1有升高趋势（11.0 ng/mL vs. 24.3 ng/mL vs. 59.6 ng/mL，严重程度不同）。血清HO-1与血清乳酸脱氢酶（R = 0.422）、C反应蛋白（R = 0.463）、磨玻璃样阴影（GGO）及胸部CT实变评分（R = 0.625）相关。血清HO-1比血清sCD 163具有更好的预测ICU入院的曲线下面积（AUC）（HO-1; 0.816和sCD 163; 0.743）。此外，包括血清HO-1和GGO和巩固评分在内的复合参数预测ICU入院的AUC高于单一参数的AUC。在临床上，血清HO-1反映了M2的活化，可能是评估疾病严重程度和预测COVID-19患者病情的一个非常有用的标志物。此外，控制激活的M2可能是预防COVID-19的治疗靶点。
A cytokine storm is caused by inflammatory cells, including pro-inflammatory macrophage phenotype (M1), and play a critical role in the pathogenesis of COVID-19, in which diffuse alveolar damage occurs in the lungs due to oxidative stress exposure. Heme oxygenase (HO)-1 is a stress-induced protein produced by the anti-inflammatory / anti-oxidative macrophage phenotype (M2), which also produces soluble CD163 (sCD163). In our study, we investigated and determined that serum HO-1 can be a predictive biomarker for assessing both the severity and the outcome of COVID-19 patients. The serum concentrations of HO-1 and sCD163 of COVID-19 patients were measured on admission. The relationship between these biomarkers and other clinical parameters and outcomes were evaluated. Sixty-four COVID-19 patients (11 mild, 38 moderate, and 15 severe cases) were assessed. The serum HO-1 tended to increase (11.0 ng/mL vs. 24.3 ng/mL vs. 59.6 ng/mL with severity). Serum HO-1 correlated with serum lactate dehydrogenase (R = 0.422), C-reactive protein (R = 0.463), and the ground glass opacity (GGO) and consolidation score (R = 0.625) of chest computed tomography. The serum HO-1 showed a better area under the curve (AUC) for predicting ICU admission than the serum sCD163 (HO-1; 0.816 and sCD163; 0.743). In addition, composite parameters including serum HO-1 and the GGO and consolidation score showed a higher AUC for predicting ICU admission than the AUC of a single parameter. Clinically, serum HO-1, reflecting the activation of M2, could be a very useful marker for evaluating disease severity and predicting prognoses for COVID-19 patients. In addition, controlling activated M2 might be a preventative COVID-19 therapeutic target.
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