Authors

Gengyu Shi1, Mingyang Liu2, Zhiyong Yuan1, Lisha Wang3, Shichao Cui4, Jinyan Xing1, *


Departments

1Department of Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, PR China - 2Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, PR China - 3Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, PR China - 4Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, PR China

Abstract

Objective: To explore the correlation between lnc-DC and sepsis in the dendritic cells (DC) of peripheral blood and to determine the monitoring value of lnc-DC in patients with sepsis.

Methods: This study used the prospective randomized controlled trial method, in which 50 patients with sepsis admitted to the Department of Intensive Care Unit, Affiliated Hospital of Qingdao University from January 2015 to December 2016 were randomly selected as the treatment group according to the random digital table method, and 13 healthy volunteers were selected as the control group. In the stratified analysis, 34 of the 50 sepsis patients had severe sepsis, and 16 patients had multiple organ dysfunction syndrome (MODS). The basic condition of all the patients was recorded. Peripheral venous blood was extracted by RT-PCR to detect the lnc-DC level, and each patient’s Sequential Organ Failure Assessment score (SOFA score) was evaluated. In addition, each patient’s procalcitonin (PCT) level was recorded, and the survival or death condition was recorded after 28 days of follow-up.

Results: For the two variants of lnc-DC, the expression of variant 1 was higher than that of variant 2 (p<.001). The levels of lnc-DC in peripheral blood DC of patients in the sepsis, severe sepsis and MODS groups were significantly lower than in the control group. (sepsis group vs control group (Pvariant 1 = 0.042, Pvariant 2 = 0.028); severe sepsis group vs control group (Pvariant 1 = 0.034, Pvariant 2 = 0.01); MODS group vs control group (Pvariant 1 = 0.001, Pvariant 2 = 0.001). Stratified analysis showed that the lnc-DC levels in peripheral blood DC in the MODS group were lower than that in the sepsis and severe sepsis groups. (MODS group vs severe sepsis group (Pvariant 1 = 0.025, Pvariant 2 = 0.037); MODS group vs sepsis group (Pvariant 1 = 0.006, Pvariant 2 = 0.01). The levels of lnc-DC in peripheral blood DC in the severe sepsis group were lower than that in the sepsis group, but the difference was not statistically significant. (severe sepsis group vs sepsis group (Pvariant 1 = 0.614, Pvariant 2 = 0.406). The levels of lnc-DC in peripheral blood DC of patients in the sepsis, severe sepsis and MODS groups were correlated with PCT and death.(correlation between lnc-DC level and PCT in sepsis group: Pvariant 1<0.001, rvariant 1 = -0.546; Pvariant 2<0.001, rvariant 2 = -0.478; correlation between lnc-DC level and PCT in severe sepsis group: Pvariant 1<0.001, rvariant 1 = -0.601; Pvariant 2 = 0.002, rvariant 2 = -0.514; correlation between lnc-DC level and PCT in MODS group: Pvariant 1 = 0.003, rvariant 1 = -0.695; Pvariant 2 = 0.02, rvariant 2 = -0.576; correlation between lnc-DC level and death in sepsis group: AUCvariant 1 = 0.686, Pvariant 1 = 0.032; AUCvariant 2 = 0.684, Pvariant 2 = 0.034; correlation between lnc-DC level and death in severe sepsis group: AUCvariant 1 = 0.746, Pvariant 1 = 0.026; AUCvariant 2 = 0.833, Pvariant 2 = 0.002; correlation between lnc-DC level and death in MODS group: AUCvariant 1 = 0.813, Pvariant 1 = 0.036; AUCvariant 2 = 0.844, Pvariant 2 = 0.021). The lnc-DC level in peripheral blood DC of patients in the sepsis, severe sepsis and MODS groups was not associated with SOFA scores.

Conclusion: The expression of lnc-DC decreased in patients in the sepsis, severe sepsis and MODS groups. The more severe the disease was, the lower the expression level was, and it was associated with death and PCT. So, it can be used as an indicator of the diagnosis, severity and prognosis of sepsis.

Keywords

Sepsis, dendritic cells (DC), lnc-DC.

DOI:

10.19193/0393-6384_2021_2_157