Abstract

BackgroundSepsis biomarkers have limited specificity and sensitivity. Few studies have investigated microRNA (miRNA) biomarkers for sepsis secondary to pneumonia. This study aims to investigate the diagnostic and prognostic values of miRNAs in sepsis secondary to pneumonia.MethodsSepsis 3.0 was used to diagnose sepsis. Screening was performed through the Agilent miRNA chip technology by using the following criteria: p < 0.05, fold ≥2 or < 0.5, or copy number > 50 change. This study recruited 52 patients with pneumonia, including 31 males (59.6%) and 21 females (40.4%), 44 patients with sepsis secondary to pneumonia were diagnosed via Sepsis 3.0 (34 [77.3%] males and 10 [22.7%] females), and 21 healthy controls were used for miRNA verification. The miRNA levels were detected through fluorescence real-time quantitative polymerase chain reaction (qRT-PCR). Results: Fluorescence qRT-PCR detection showed that the miR-7110-5p and miR-223-3p expression levels in both patient groups were upregulated compared with those in the healthy controls. The expression levels differed between patients with pneumonia and those with sepsis secondary to pneumonia. The sensitivity and specificity of miR-7110-5p to differentiate sepsis from healthy controls were 84.2 and 90.5%, whereas those of miR-223-3p were 82.9 and 100%, respectively. Multivariate analysis of variance suggested that the presence of sepsis affected the miR-223-3p level (p = 0.041), whereas the presence of sepsis (p = 0.000) and the underlying disease (p = 0.025) influenced the miR-7110-5p level.ConclusionsMiR-223-3p could be utilized to predict sepsis secondary to pneumonia.

Highlights

  • Sepsis biomarkers have limited specificity and sensitivity

  • This study aimed to identify the differences in microRNA expression in patients affected with pneumonia and with sepsis secondary to pneumonia

  • Pneumonia was diagnosed in accordance with the diagnosis and treatment guidelines of hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP) drafted by the American Thoracic Society and the Infectious Diseases Society of America in 2007 and 2016 [8, 9]

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Summary

Introduction

Sepsis biomarkers have limited specificity and sensitivity. Few studies have investigated microRNA (miRNA) biomarkers for sepsis secondary to pneumonia. This study aims to investigate the diagnostic and prognostic values of miRNAs in sepsis secondary to pneumonia. Sepsis is a major cause of death in critical patients. It remains a remarkable challenge in clinical medicine because of its high mortality and morbidity rates. The incidence of sepsis reaches 100/ 100,000 [1], and approximately 2% of hospitalized patients. MicroRNAs (miRNAs) are endogenous noncoding small RNAs of approximately 21–25 nucleotides in length. Whole panels of deregulated miRNAs have been described in the blood of patients with inflammatory/infectious diseases, thereby suggesting that circulating miRNAs might be suitable biomarkers in sepsis [7]

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