■脓毒症代表感染的严重表现,通常伴有代谢紊乱和线粒体功能障碍。值得注意的是,线粒体DNA拷贝数(mtDNA-CN)和特定线粒体基因的表达已成为线粒体功能的敏感指标。探讨外周血细胞线粒体基因表达在区分严重感染和预测相关结局中的应用。我们进行了一项前瞻性队列研究.
■我们建立了一个前瞻性队列,包括74例非脓毒症肺炎患者和67例由呼吸道感染引起的脓毒症患者。年龄从2岁到6岁。我们记录了相应的临床数据和实验室信息,并在初次入院时收集了血液样本。及时分离外周血细胞,提取总DNA和RNA。我们利用绝对定量PCR来评估mtDNA-CN,以及mt-CO1、mt-ND1和mt-ATP6的表达水平。随后,我们使用单变量和多变量分析将这些比较扩展到包括脓毒症患者的幸存者和非幸存者.构建受试者工作特征(ROC)曲线以评估诊断潜力。
■脓毒症组外周血细胞中的mtDNA-CN显著降低。单因素分析显示,脓毒症患者mt-CO1,mt-ND1和mt-ATP6的表达显着降低。然而,多变量分析不支持使用外周血细胞中的线粒体功能来诊断脓毒症。在儿科败血症幸存者和非幸存者之间的比较,单变量分析表明,非存活者中mt-CO1,mt-ND1和mt-ATP6的表达显著降低.值得注意的是,总胆红素(TB),mt-CO1、mt-ND1和mt-ATP6水平被确定为脓毒症死亡率的独立危险因素。然后建立这些独立危险因素的ROC曲线,显示TB的曲线下面积(AUC)为0.753(95%CI0.596-0.910),mt-CO1为0.870(95%CI0.775-0.965),mt-ND1为0.987(95%CI0.964-1.000),mt-ATP6为0.877(95%CI0.793-0.962)。
■MtDNA-CN和线粒体基因表达与感染性疾病的严重程度和临床结果密切相关。严重感染导致外周血细胞线粒体功能受损。值得注意的是,与其他实验室参数相比,mt-CO1,mt-ND1和mt-ATP6的表达水平在评估小儿脓毒症的预后方面具有良好的潜力.
UNASSIGNED: Sepsis represents a severe manifestation of infection often accompanied by metabolic disorders and mitochondrial dysfunction. Notably, mitochondrial DNA copy number (mtDNA-CN) and the expression of specific mitochondrial genes have emerged as sensitive indicators of mitochondrial function. To investigate the utility of mitochondrial gene expression in peripheral blood cells for distinguishing severe infections and predicting associated outcomes, we conducted a prospective cohort study.
UNASSIGNED: We established a prospective cohort comprising 74 patients with non-sepsis pneumonia and 67 cases of sepsis induced by respiratory infections, aging from 2 to 6 years old. We documented corresponding clinical data and laboratory information and collected blood samples upon initial hospital admission. Peripheral blood cells were promptly isolated, and both total DNA and RNA were extracted. We utilized absolute quantification PCR to assess mtDNA-CN, as well as the expression levels of mt-CO1, mt-ND1, and mt-ATP6. Subsequently, we extended these comparisons to include survivors and non-survivors among patients with sepsis using univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic potential.
UNASSIGNED: The mtDNA-CN in peripheral blood cells was significantly lower in the sepsis group. Univariate analysis revealed a significant reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 in patients with sepsis. However, multivariate analysis did not support the use of mitochondrial function in peripheral blood cells for sepsis diagnosis. In the comparison between pediatric sepsis survivors and non-survivors, univariate analysis indicated a substantial reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 among non-survivors. Notably, total bilirubin (TB), mt-CO1, mt-ND1, and mt-ATP6 levels were identified as independent risk factors for sepsis-induced mortality. ROC curves were then established for these independent risk factors, revealing areas under the curve (AUCs) of 0.753 for TB (95% CI 0.596-0.910), 0.870 for mt-CO1 (95% CI 0.775-0.965), 0.987 for mt-ND1 (95% CI 0.964-1.000), and 0.877 for mt-ATP6 (95% CI 0.793-0.962).
UNASSIGNED: MtDNA-CN and mitochondrial gene expression are closely linked to the severity and clinical outcomes of infectious diseases. Severe infections lead to impaired mitochondrial function in peripheral blood cells. Notably, when compared to other laboratory parameters, the expression levels of mt-CO1, mt-ND1, and mt-ATP6 demonstrate promising potential for assessing the prognosis of pediatric sepsis.