Abstract
BackgroundThe elderly hip fracture is one of the most common injuries and represents a high incidence of complications and mortality. Among these complications, acute lung injury (ALI) and subsequent pulmonary dysfunction are the most serious and fatal. It is still uncertain why elderly patients more easily suffer it and younger do not under almost similar clinical conditions. For early diagnosis and prevention of ALI after fracture, it is very necessary to find some biomarkers for it. ObjectiveThis study aims to examine the differential expression of miR-146a, miR-150 and cytokines (TNF-a, IL-6, and IL-10) between younger and elderly rats suffering from hip fracture and to investigate the possible meaning of them in early diagnosis and prognosis of ALI after hip fracture. Methods and subjectsForty elderly rats and 40 younger rats were randomly divided into two groups respectively (sham group and fracture group). Two sham groups only received anaesthesia, cannulation and observation. Two fracture groups received hip fracture operations. The rats were respectively sacrificed at 4, 12, 24, and 48h after hip fracture or anaesthesia. Blood samples and lung tissues were collected for further examination. The damage degree of ALI was evaluated by histological observation and pathological score on lung tissue slices. Cytokines were measured by enzyme-liked immunosorbent assay (ELISA); miR-146a and miR-150 were analysed by quantitative real-time PCR (qRT-PCR). ResultsAt 4, 12, 24, and 48h after treatment, the pulmonary histological score and serum concentrations of miR-146a, miR-150, and cytokines (TNF-a, IL-6, and IL-10) had no significant difference between elderly sham group and younger sham group; however, compared with the corresponding sham groups (elderly fracture group vs. elderly sham group, younger fracture group vs. younger sham group), the pulmonary histological score and serum levels of TNF-a, IL-6, IL-10, and miR-146a were significantly higher (whereas the miR-150 were lower) in fracture groups (except the TNF-a and IL-10 of younger fracture group at 48h). At 24 and 48h after fracture, between two fracture groups, the pulmonary histological score and serum levels of TNF-a, IL-6, IL-10, and miR-146a were higher (whereas the miR-150 were lower) in elderly fracture group (except the TNF-a at 48h). The results of linear regression analysis shown that the serum levels of cytokines (TNF-a, IL-6, and IL-10) were not significantly related with pulmonary histological score, however, the serum levels of miR-146a and miR-150 were significantly associated with it. ConclusionHip fracture can result in significant systemic inflammation and ALI in rats. Compared to younger, the elderly rats suffered a more remarkable ALI after hip fracture. It may be related to the abnormal expression of miR-146a and miR-150. Serum miR-146a and miR-150 are potential biomarkers for early diagnosis and prognosis of ALI after hip fracture.
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