Value Of Plasma MiRNA-122a, MiRNA-146a And MiRNA-155a Expression For The Diagnostic And Prognostic Evaluation Of Sepsis

Background and Aims With the development of treatment technology,outcomes of sepsis have greatly improved.But sepsis is still a life-threatening condition,which is the leading cause of death in Intensive Care Units.One of the main reasons is the difficulty of early recognition of sepsis,if we could find a specific biomarker related to sepsis diagnosis,new specific therapies might be developed and mortality reduced.Recent studies have confirmed that miRNA is associated with a variety of diseases,which is also specifically express in sepsis.Whether the miRNA can been used as finger prints for sepsis.Our goal in this study is to investigate if plasma miRNA-122 a,miRNA-146 a,miRNA-155 a can diagnose sepsis as biomarker,which to provide theoretical basis for the early diagnosis of sepsis.Methods 103 patients with sepsis were selected as study subjects.They were divided into sepsis group(71 cases)and septic shock group(32 cases).At the same time,30 healthy persons were selected as the control group.Reverse transcription polymerase chain reaction(RT-PCR)was used to determine the expression of microRNA-122 a,micro RNA-146 a and microRNA-155 a,and collected the clinical data of the subjects.Using the receiver-operating characteristic curve(ROC)to evaluate the diagnostic value of microRNAs.According to the 28 days-outcome,patients were divided into the survival group(75 cases),the death group(28 cases).Using the binary logistic regression to analyze the risk factors of the prognosis of patients with sepsis.Results(1)The expressions of plasma microRNA-122 a,microRNA-155 a increased with the aggravation of sepsis(P<0.05),while microRNA-146 a decreased(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC)of plasma microRNA-122 a,microRNA-146 a,microRNA-155 a for the diagnosis of sepsis were 0.787 [95% confidence interval(95%CI)= 0.703-0.872],0.732(95%CI = 0.629-0.835)and 0.740(95%CI= 0.635-0.844).(2)Compared with the survival group,the disease severity,SOFA score,APACHE?score,CRP(C-reactive protein),PCT(procalcitonin),Lac(lactic acid),microRNA-122 a,microRNA-155 a of the 28 days-death group significantly increased(P<0.05),But the expression of microRNA-146 a significantly decreased(P<0.05);and the gender,age,WBC(white blood cell)showed no significant difference(P>0.05).Binary logistic regression analysis showed that the severity of sepsis,SOFA score,APACHE?score,microRNA-122 a and microRNA-155 a are the risk factors affecting the prognosis.Conclusion(1)The plasma microRNA-122 a,microRNA-146 a,microRNA-155 a can be used as specific biomarkers for the diagnosis of sepsis.(2)The plasma microRNA-122 a,microRNA-146 a,micro RNA-155 a have positive clinical significance for judging severity of sepsis.3.The plasma microRNA-122 a,microRNA-155 a are independent risk factors for sepsis.