Abstract:

Objective To study the expression and clinical significance of autophagy ⁃ related proteins in sepsis patients with acute respiratory distress syndrome（ARDS）. Methods The mRNA and protein expression levels of autophagy⁃related factors（Beclin⁃1，LC3⁃II，p62）in each group of mononuclear cells（PBMCs）were detected by qRT⁃PCR and western blotting；The related cytokines（IL⁃1β，TNF⁃ α，IL⁃6，IL⁃10）levels were measured by enzyme⁃linked immunosorbent assay（ELISA）. The differences of the above indicators in each group were compared and the prognostic value of autophagy⁃related proteins in sepsis patients with ARDS was evaluated. Results Compared with the non⁃ARDS group，the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs，and IL⁃10 in peripheral blood of ARDS group were significantly reduced，while the mRNA and pro⁃ tein expression levels of p62，the IL⁃1β，TNF⁃α and IL⁃6 levels in peripheral blood were increased（P < 0.05）. Compared with the survival group，the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs， and IL⁃10 in peripheral blood of ARDS group were significantly reduced，while the mRNA and protein expression levels of p62，the IL⁃1β，TNF⁃α and IL⁃6 levels in peripheral blood were increased（P < 0.05）. In ARDS group， Beclin⁃1 and LC3⁃II mRNA were significantly negatively correlated with peripheral blood IL⁃1β and TNF⁃α levels， respectively；while p62 mRNA was significantly positively correlated with peripheral blood IL⁃1β and TNF⁃ α levels. ROC curve analysis showed that the AUCs of Beclin⁃1 mRNA，LC3⁃II mRNA and p62 mRNA to distinguish surviving and non⁃surviving patients were 0.818（95%CI，0.743 ~ 0.913），0.829（95%CI，0.738 ~ 0.921），and 0.794（95%CI，0.705 ~ 0.883），respectively. Those sensitivity was 75.96%，81.82% and 71.19%；the specificity was 80.49% ，75.61% and 71.23% ，respectively. Conclusion The reduction of autophagy was involved in the occurrence and development ofsepsis complicated with ARDS. It has certain clinical value for the evaluation of prognosis by detecting the level of autophagy.

Key words:

autophagy?related proteins, sepsis, acute respiratory distress syndrome, tumor necrosis factor?α, prognosis