Abstract
Background and PurposeMitochondrial DNA (mtDNA), a newly identified damage-associated molecular pattern, has been observed in trauma patients, however, little is known concerning the relationship between plasma mtDNA levels and concrete post-traumatic complications, particularly systemic inflammatory response syndrome (SIRS). The aim of this study is to determine whether plasma mtDNA levels are associated with injury severity and cloud predict post-traumatic SIRS in patients with acute traumatic injury.Patients and MethodsEighty-six consecutive patients with acute traumatic injury were prospectively enrolled in this study. The plasma mtDNA concentration was measured by a real-time, quantitative PCR assay for the human ND2 gene. The study population’s clinical and laboratory data were analyzed.ResultsThe median plasma mtDNA was higher in trauma patients than in healthy controls (865.196 (251.042-2565.40)pg/ml vs 64.2147 (43.9049-80.6371)pg/ml, P<0.001) and was independently correlated with the ISS score (r=0.287, P<0.001). The plasma mtDNA concentration was also significantly higher in patients who developed post-traumatic SIRS than in patients who did not (1774.03 (564.870-10901.3)pg/ml vs 500.496 (145.415-1285.60)pg/ml, P<0.001). Multiple logistic regression analysis revealed that the plasma mtDNA was an independent predictors for post-traumatic SIRS (OR, 1.183 (95%CI, 1.015-1.379), P=0.032). Further ROC analysis demonstrated that a high plasma mtDNA level predicted post-traumatic SIRS with a sensitivity of 67% and a specificity of 76%, with a cut-off value of 1.3185 µg/ml being established, and the area under the ROC curves (AUC) was 0.725 (95% CI 0.613-0.837).ConclusionsPlasma mtDNA was an independent indictor with moderate discriminative power to predict the risk of post-traumatic SIRS.
Highlights
Trauma is a global public health problem and is the leading cause of death among people who are below 45 years of age
Thirty-six of the 86 (41.86%) patients were diagnosed with post-traumatic systemic inflammatory response syndrome (SIRS) during the course of the disease
We demonstrated that the plasma Mitochondrial DNA (mtDNA) concentration was positively correlated with markers of systemic inflammatory response in terms of neutrophil-to-lymphocyte ratio (NLR)
Summary
Trauma is a global public health problem and is the leading cause of death among people who are below 45 years of age. The potential of anti-inflammatory agents for modifying inflammatory processes has been clearly established, large-scale clinical studies investigating anti-inflammatory interventions using such modulators have frequently shown little benefit in terms of patient survival [4,5,6]. The failure of these trials has been attributed partially to the current inability to accurately identify high-risk patients at an early stage after injury [7].
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