| Background Acute pancreatitis(AP) is an acute parenchymal injury of the pancreas, and is a kind of inflammatory diseases with complex mechanism. Due to the lack of specific and effective clinical treatment, AP is still a challenging problem, so research on AP inflammation regulation mechanism may be the development of new methods of diagnosis and treatment. According to the severity, AP can be divided into three categories: severe acute pancreatitis(SAP), moderately severe acute pancreatitis(MSAP) and mild acute pancreatitis(MAP). MSAP and SAP's development involves consistent critical conditions, which is presently showing a case fatality rate 36%-50%. The pathogenesis of acute pancreatitis is complicated by multiple factors, including “pancreatic autodigestion theory”, “theory of intestinal barrier dysfunction”, “inflammation medium theory” and “theory of apoptosis” etc. Intestinal barrier dysfunction will lead to endotoxemia and multiple organ failure, and promote the development of the disease, and the main factors which maintain the stability of intestinal barrier function are the tight junction and the integrity of the intestinal mucosal epithelial cells. To clarify the function of intestinal mucosal barrier damage mechanism will contribute to the success in the treatment of MSAP and SAP patients. On the other hand, the causes of high fatality rate of AP, causing high mortality of AP, have disease much urgenter suddenly. Imaging findings are not immediately apparent, and can not be determine rapidly condition the degree of development. Therefore, improving the early diagnosis is the important factor to reduce the mortality rate. micro RNA(mi RNA) constitute a class of non-protein encoding RNA molecules which have now emerged as key players in regulating the activity of target m RNA, including inflammation. It is not only tissue specific expression, when some organ damage, it can be released into the blood and expressed stably, which can be used as a biomarker for early diagnosis of diseases. mi R-155, transcription from a non encoding gene known as B-cell integration cluster and is located in the third exon, is a multifunctional mi RNA. It has the ability to regulate various immune and inflamematory response, and play a role in the production of inflammatory factors, differentiation of T cells, antigen presentation and so on, which express almost in all kinds of immune cells, is the main medium to regulate early inflammatory process. It is overexpressed in intestinal epithelial of AP patients,which mediated by TNF-?. TNF-? regulates mi R-155 overexpression inhibits AJC component protein syntheses of ZO-1, and E-cadherin by downregulating post-transcriptional Rho A expression,leads to intestinal barrier dysfunction and disease progression in AP. mi R-155 plays an important role in the development of the occurrence of AP, and it can be stable expressed in peripheral blood, so it is likely to be marker in early diagnosis of AP, which can determine patient grading and prognosis and guide the diagnosis and treatment, and it will provide great help for clinical work. The purpose of this study is to research mi R-155 expression in AP and its clinical significance.Objective To explore the serum expression level and clinical significance of mi R-155 in AP patients.The relative expression of mi R-155 in peripheral blood of 3 groups were detected by real-time fluorescent quantitative PCR technique. Twenty-eight patients with MSAP or SAP(13 males and 15 females, median age was 46 years old)were included in group A, 32 patients with MAP(18 males and 14 females, median age was 43 years old)were included in group B, and 20 healthy people were included as normal control(NC)(10 males and 10 females, median age was 43 years old). The differences of the mi R-155 expression level in various groups were assayed, and the correlation between mi R-155 expression levels and clinical characteristics of AP patients were analyzed. Then a receiver operating characteristic curve(ROC curve) was made to explore the diagnostic value of serum mi R-155. MethodsResults 1. The mean relative expression level of serum mi R-155 were 8.09±2.28 in group A, 4.94±1.41 in group B, and 1.58±0.81 in the NC group. A statistically significance(P<0.05) was achieved between higher and lower mi R-155 level groups(A vs B, A vs NC, B vs NC). 2. The relative expression levels of mi R-155 was significantly correlated with patients' BISAP score, Ranson score, APACHE II score and MCTSI score(P<0.05), but not correlate with the patients' gender and age(P>0.05). 3. The area under ROC curve was 0.882, the sensitivity and specificity were 92.5% and 85.7% respectively, and the best cutoff to predict AP was 3.55.Conclusion 1. Serum mi R-155 may be a potential biomarker for the diagnosis of AP clinically. 2. Serum mi R-155 may be useful for the prediction of the severity of AP. |
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