Correlation among expression level of circulating miR-126，risk of acute respiratory distress syndrome，and septic severity and prognosis in patients with sepsis

Abstract:

Objective：To assess the predictive role of plasma microRNA（miR）-126 on risk of acute respiratory distress syndrome （ARDS） in patients with sepsis，and to investigate the correlation of miR-126 and sepsis severity，inflammation level and prognosis. Methods：A total of 172 patients with sepsis were continuously enrolled. Peripheral blood samples of patients were collected within 24 hours after admission，and plasma was separated；expression level of miR-126 was detected by quantitive polymerase chain reaction. Expression levels of inflammatory cytokines[including tumor necrosis factor-α（TNF-α），interleukin（IL）-1β，IL-6 and IL-17） in plasma were detected by enzyme-linked immune sorbent assay（ELISA）. Meanwhile，the 28-day mortality was recorded as well. Results：Among them，50 patients（30.8%） had ARDS during hospitalization，and plasma miR-126 expression was significantly elevated in ARDS patients when compared with non-ARDS patients（P<0.001）. According to the receiver operating characteristic curve（ROC） analysis，expression level of plasma miR-126 was able to differentiate ARDS patients form non-ARDS patients，with area under the ROC（AUC） of 0.741（95%CI=0.666-0.815）. In accordance with the multivariate logistic regression model analysis，high expression of miR-126（P<0.001） was the independent predictive factor for relative-high onset-risk of ARDS. In addition，of all sepsis patients，plasma miR-126 expression was positively correlated with levels of serum creatinine（P=0.004），C reactive protein（P<0.001），procal－citonin（P<0.001），acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score（P<0.001），sequential organ failure as－sessment（SOFA） score（P<0.001），and inflammatory factors of TNF-α（P=0.001），IL-1β（P=0.002），IL-6（P=0.011） and IL-17（P=0.002）. Moreover，the expression level of plasma miR-126 in the dead was significantly higher than that in the survivors（P<0.001）. According to the ROC curve analysis，it was able to predict that patients with sepsis had a high 28-day mortality risk，with AUC of 0.686（95%CI=0.601-0.771）. Conclusion：Higher circulating miR-126 expression can predict the higher ARDS in－cidence in patients with sepsis，and can serve as a biomarker for disease surveillance and patients’ prognosis in sepsis.