BACKGROUND:The molecular mechanism of sepsis-associated acute kidney injury(SA-AKI)is unclear.We analyzed co-differentially expressed genes(co-DEGs)to elucidate the underlying mechanism and intervention targets of SA-...BACKGROUND:The molecular mechanism of sepsis-associated acute kidney injury(SA-AKI)is unclear.We analyzed co-differentially expressed genes(co-DEGs)to elucidate the underlying mechanism and intervention targets of SA-AKI.METHODS:The microarray datasets GSE65682,GSE30718,and GSE174220 were downloaded from the Gene Expression Omnibus(GEO)database.We identified the co-DEGs and constructed a gene co-expression network to screen the hub genes.We analyzed immune correlations and disease correlations and performed functional annotation of the hub genes.We also performed single-cell and microenvironment analyses and investigated the enrichment pathways and the main transcription factors.Finally,we conducted a correlation analysis to evaluate the role of the hub genes.RESULTS:Interleukin 32(IL32)was identified as the hub gene in SA-AKI,and the main enriched signaling pathways were associated with hemopoiesis,cellular response to cytokine stimulus,inflammatory response,and regulation of kidney development.Additionally,IL32 was significantly associated with mortality in SA-AKI patients.Monocytes,macrophages,T cells,and NK cells were closely related to IL32 and were involved in the immune microenvironment in SA-AKI patients.IL32 expression increased significantly in the kidney of septic mouse.Toll-like receptor 2(TLR2)was significantly and negatively correlated with IL32.CONCLUSION:IL32 is the key gene involved in SA-AKI and is significantly associated with prognosis.TLR2 and relevant immune cells are closely related to key genes.展开更多
The neutrophil-to-lymphocyte ratio (NLR) is an important predictive prognostic tool. However, its accuracy for predicting sepsis remains debatable. This study aimed to evaluate the factors influencing the ability of N...The neutrophil-to-lymphocyte ratio (NLR) is an important predictive prognostic tool. However, its accuracy for predicting sepsis remains debatable. This study aimed to evaluate the factors influencing the ability of NLR to predict sepsis. Adult patients with sepsis or septic shock from the eICU database were enrolled in this study. Results showed that there was a significant difference in NLR between the survival and nonsurvival groups (median [lower quartile–upper quartile], 15.27 [7.92–26.28] vs. 17.97 [8.94–31.85], P = 0.008). Area under the curve (AUC) of NLR on the sixth day was the highest. AUC of NLR was significantly higher in the Simplified Acute Physiological Score (SAPS) 3 ≤52 group than that in the SAPS3 > 52 group (0.78 ± 0.05 vs. 0.69 ± 0.03, P = 0.007). AUC of NLR in the nonshock group was significantly higher than that in the shock group (0.72 ± 0.04 vs. 0.65 ± 0.05, P < 0.01). The ability of NLR as a prognosis predictor of sepsis was influenced by admission time, SAPS3, and shock.展开更多
Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in a...Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in adult septic patients.Methods:Data search included Pumbed,EMBASE,and the Cochrane Library from inception to Sep,2021.Only studies with classifications of sepsis and intravenous HAT treatment were included.Adult patients with sepsis(aged≥18 years)were divided into 2 groups.The treatment group received HAT therapy,whereas the control group received standard care and/or intravenous hydrocortisone.The primary outcome was hospital mortality.Results:Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed(6 randomized controlled trials[RCTs]and 5 clinical cohort studies).No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference(OR:0.99;95%CI:0.77 to 1.27;I^(2)=39%)group.Sequential organ failure assessment(SOFA)score decrement at 72hours was more significant in HAT-treated patients(mean difference[MD]:–1.23;95%CI:–1.94 to–0.53;I^(2)=81%).There was no difference in the duration of vasopressor use between HAT-treated patients and controls(MD:–4.92;95%CI:–24.38 to 14.53;I^(2)=97%).Statistical heterogeneity was noted with no sign of significant publication bias.Conclusion:In adult sepsis and septic shock patients,HAT treatment failed to reduce mortality or shorten vasopressor duration,but reduced SOFA scores.展开更多
基金supported by Beijing Natural Science Foundation(No.7222162 to Dr.Hui Liu)。
文摘BACKGROUND:The molecular mechanism of sepsis-associated acute kidney injury(SA-AKI)is unclear.We analyzed co-differentially expressed genes(co-DEGs)to elucidate the underlying mechanism and intervention targets of SA-AKI.METHODS:The microarray datasets GSE65682,GSE30718,and GSE174220 were downloaded from the Gene Expression Omnibus(GEO)database.We identified the co-DEGs and constructed a gene co-expression network to screen the hub genes.We analyzed immune correlations and disease correlations and performed functional annotation of the hub genes.We also performed single-cell and microenvironment analyses and investigated the enrichment pathways and the main transcription factors.Finally,we conducted a correlation analysis to evaluate the role of the hub genes.RESULTS:Interleukin 32(IL32)was identified as the hub gene in SA-AKI,and the main enriched signaling pathways were associated with hemopoiesis,cellular response to cytokine stimulus,inflammatory response,and regulation of kidney development.Additionally,IL32 was significantly associated with mortality in SA-AKI patients.Monocytes,macrophages,T cells,and NK cells were closely related to IL32 and were involved in the immune microenvironment in SA-AKI patients.IL32 expression increased significantly in the kidney of septic mouse.Toll-like receptor 2(TLR2)was significantly and negatively correlated with IL32.CONCLUSION:IL32 is the key gene involved in SA-AKI and is significantly associated with prognosis.TLR2 and relevant immune cells are closely related to key genes.
基金funded with support from Beijing Natural Science Foundation(No.7222162).
文摘The neutrophil-to-lymphocyte ratio (NLR) is an important predictive prognostic tool. However, its accuracy for predicting sepsis remains debatable. This study aimed to evaluate the factors influencing the ability of NLR to predict sepsis. Adult patients with sepsis or septic shock from the eICU database were enrolled in this study. Results showed that there was a significant difference in NLR between the survival and nonsurvival groups (median [lower quartile–upper quartile], 15.27 [7.92–26.28] vs. 17.97 [8.94–31.85], P = 0.008). Area under the curve (AUC) of NLR on the sixth day was the highest. AUC of NLR was significantly higher in the Simplified Acute Physiological Score (SAPS) 3 ≤52 group than that in the SAPS3 > 52 group (0.78 ± 0.05 vs. 0.69 ± 0.03, P = 0.007). AUC of NLR in the nonshock group was significantly higher than that in the shock group (0.72 ± 0.04 vs. 0.65 ± 0.05, P < 0.01). The ability of NLR as a prognosis predictor of sepsis was influenced by admission time, SAPS3, and shock.
文摘Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in adult septic patients.Methods:Data search included Pumbed,EMBASE,and the Cochrane Library from inception to Sep,2021.Only studies with classifications of sepsis and intravenous HAT treatment were included.Adult patients with sepsis(aged≥18 years)were divided into 2 groups.The treatment group received HAT therapy,whereas the control group received standard care and/or intravenous hydrocortisone.The primary outcome was hospital mortality.Results:Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed(6 randomized controlled trials[RCTs]and 5 clinical cohort studies).No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference(OR:0.99;95%CI:0.77 to 1.27;I^(2)=39%)group.Sequential organ failure assessment(SOFA)score decrement at 72hours was more significant in HAT-treated patients(mean difference[MD]:–1.23;95%CI:–1.94 to–0.53;I^(2)=81%).There was no difference in the duration of vasopressor use between HAT-treated patients and controls(MD:–4.92;95%CI:–24.38 to 14.53;I^(2)=97%).Statistical heterogeneity was noted with no sign of significant publication bias.Conclusion:In adult sepsis and septic shock patients,HAT treatment failed to reduce mortality or shorten vasopressor duration,but reduced SOFA scores.
