Circulating MicroRNA-150 Serum Levels Predict Survival in Patients with Critical Illness and Sepsis

Background and AimsDown-regulation of miR-150 was recently linked to inflammation and bacterial infection. Furthermore, reduced serum levels of miR-150 were reported from a small cohort of patients with sepsis. We thus aimed at evaluating the diagnostic and prognostic value of miR-150 serum levels in patients with critically illness and sepsis.MethodsmiR-150 serum levels were analyzed in a cohort of 223 critically ill patients of which 138 fulfilled sepsis criteria and compared to 76 healthy controls. Results were correlated with clinical data and extensive sets of routine and experimental biomarkers.ResultsMeasurements of miR-150 serum concentrations revealed only slightly reduced miR-150 serum levels in critically ill patients compared to healthy controls. Furthermore miR-150 levels did not significantly differ in critically ill patients with our without sepsis, indicating that miR-150 serum levels are not suitable for diagnostic establishment of sepsis. However, serum levels of miR-150 correlated with hepatic or renal dysfunction. Low miR-150 serum levels were associated with an unfavorable prognosis of patients, since low miR-150 serum levels predicted mortality with high diagnostic accuracy compared with established clinical scores and biomarkers.ConclusionReduced miR-150 serum concentrations are associated with an unfavorable outcome in patients with critical illness, independent of the presence of sepsis. Besides a possible pathogenic role of miR-150 in critical illness, our study indicates a potential use of circulating miRNAs as a prognostic rather than diagnostic marker in critically ill patients.研究背景与目的 近期有研究表明，微小RNA-150（miR-150）的下调与炎症及细菌感染密切相关。此外，一项针对脓毒症患者的小样本队列研究显示，其血清miR-150水平呈降低状态。因此本研究旨在评估重症患者及脓毒症患者血清miR-150水平的诊断及预后价值。 研究方法 本研究纳入223例重症患者（其中138例符合脓毒症诊断标准），对其血清miR-150水平进行检测，并与76名健康对照者进行对比。将检测结果与临床资料、多套常规及实验性生物标志物进行相关性分析。 研究结果 血清miR-150浓度检测结果显示，与健康对照者相比，重症患者的血清miR-150水平仅存在轻微降低。此外，合并或不合并脓毒症的重症患者之间，miR-150水平并无显著差异，这表明血清miR-150水平不适用于脓毒症的诊断确立。但血清miR-150水平与肝肾功能障碍存在相关性。低水平血清miR-150与患者不良预后相关：相较于已确立的临床评分及生物标志物，低血清miR-150水平对患者死亡风险的预测具有较高的诊断准确性。 结论 重症患者血清miR-150浓度降低与不良预后相关，且这一关联不受脓毒症存在与否的影响。除了miR-150在重症疾病中可能发挥的致病作用外，本研究还提示，循环微小RNA（circulating miRNAs）可作为重症患者的预后标志物而非诊断标志物，具备潜在的临床应用价值。