The Value Of Tim-3 Expression On Sepsis Patients

Objective:To observe the expression of T cell Ig and mucin domain protein 3(Tim-3) on monocytes and on gene level and soluble Tim-3 in plasma for sepsis patients, analysis the value of Tim-3 on predicting the prognosis of combined with APACHE Ⅱ, SOFA, and related inflammatory cytokines.Methods:Our study included 247 sepsis patients from May 2013 to January 2015. For these patients, who were divided into survival group (>28-days survival,198 patients) and non-survival group (<28-days survival,49 patients), and 43 healthy controls were included. The blood samples of these patients were collected on 1st day of ICU admission, and 11 patients in survival group and 5 patients in non-survival group were collected on days 1,3,5,7,10, and 14 after admission for dynamic observing the changes of Tim-3 expression via flow cytometry, the Tim-3 gene was detected by RT-PCR, and plasma soluble Tim-3 protein was detected by ELISA assay.Results:(1)Based on 28-days survival, expression of Tim-3(mRNA) and levels of Tim-3 protein were statistically significant differences (P<0.05), survival group was higher compared to non survival group. On the contrary, the level of sTim-3 in non survival group was higher than survival group.(2)Based on severity classification, Expression of Tim-3 protein, Tim-3 gene level, and sTim-3 level were statistically significant differences in groups (P<0.05), and the levels of Tim-3 protein and Tim-3 gene expression were firstly increased and then dcreased. The level of Tim-3 protein in severe sepsis group was highest compare to other group, Tim-3 gene expression was highest in sepsis group. And the level of sTim-3 positively correlated with the severity of sepsis patients.(3)Dynamical analyzing the levels of Tim-3 protein of monocyte surface, the level of Tim-3 in survival group were higher than that non-survival group. In survival group, the level of Tim-3 was highest on 5th day, and for non-survival group, the level of Tim-3 did not show obviously increase on observing day-points. Following with time extended, the level of Tim-3 in non-survival group obviously decreased, and there were statistical difference between the groups (P<0.05).Conclusion:Tim-3 is an important immune regulatory molecule that maintain immune homeostasis for sepsis patients. And it showed positive correlation with prognosis.