The Journal of Practical Medicine >
Correlation of serum RAGE and HMGB1 expression with the occurrence of acute respiratory distress syndrome and IFN⁃γ/IL⁃4 ratio in patients with severe pneumonia
Received date: 2023-08-25
Online published: 2024-03-08
Objective To explore the correlation between the expression level of serum Receptor for Advanced Glycation End?Product （RAGE） and High?Mobility Group Protein B1 （HMGB1） expression with the occurrence of acute respiratory distress syndrome （ARDS） and interferon?γ/interleukin?4 （IFN?γ/IL?4） ratio in patients with severe pneumonia （SP）. Methods A prospective investigation was carried out on one hundred children with SP admitted to our hospital from March 2020 to February 2022， and the participants were classified into ARDS group （n = 56） and control group （n = 44） based on the occurrence of secondary ARDS. General informations werecollected. The expression of RAGE， HMGB1， IFN?γ and IL?4 in peripheral blood was measured using Enzyme?Linked Immunosorbent Assay （ELISA）. Then multivariate Logistic regression analysis was conducted to screen the influencing factors of secondary ARDS in SP children， and the correlation with IFN?γ/IL?4 ratio was verified by pearson correlation analysis， moreover， receiver operating characteristic （ROC） curve was plotted to evaluate the value of RAGE and HMGB1 expression in predicting the occurrence of ARDS in SP children. Results There were no statistical difference in gender， age， body temperature and onset season between the two SP groups. The ARDS group had more types of pathogenic bacteria， larger ratio of the partial pressure of oxygen in arterial blood to the inspired oxygen fraction （PaO2/FiO2）， higher Acute Physiological Score （APS）， and up?regulated expression of RAGE， HMGB1， IFN?γ and IL?4， as well as larger IFN?γ/IL?4 ratio than those of control group， with statistical difference （all P < 0.05）. Multivariate Logistic regression analysis revealed that pathogen type， PaO2/FiO2 ratio， RAGE， HMGB1， IFN?γ， IL?4 and IFN?γ/IL?4 were the influencing factors for the occurrence of ARDS in children with SP. Pearson correlation test denoted that the serum RAGE and HMGB1 expression levels of SP children were positively correlated with IFN?γ， IL?4 and IFN?γ/IL?4 ratio （P < 0.05）. ROC curve found that the AUC of serum RAGE and HMGB1 in predicting the occurrence of ARDS in SP children was 0.707 and 0.750， with a sensitivity of 73.2% and 64.3%， and a specificity of 68.2% and 77.3%. The combined test of RAGE and HMGB1 in predicting the occurrence of ARDS in SP children reached an AUC of 0.848， providing a sensitivity and specificity of 80.4% and 81.8% respectively. Conclusions Serum RAGE and HMGB1 expression levels are elevated in SP children with ARDS， and the two are positively correlated with IFN?γ/IL?4 ratio. Therefore， monitoring serum RAGE and HMGB1 expression in children with ARDS secondary to SP has predictive value for the risk of ARDS in SP children.
Jingcai WANG , Chunyan GUO , Lixin YANG , Xiaoqing. JING . Correlation of serum RAGE and HMGB1 expression with the occurrence of acute respiratory distress syndrome and IFN⁃γ/IL⁃4 ratio in patients with severe pneumonia[J]. The Journal of Practical Medicine, 2024 , 40(4) : 515 -520 . DOI: 10.3969/j.issn.1006-5725.2024.04.013
| 1 | ZENG S Z， XIE L Y， YU T， et al. Persistent viral shedding of human adenovirus type 7 in children with severe pneumonia［J］. J Med Virol， 2021，93（8）：4846-4855. doi:10.1002/jmv.26864 |
| 2 | PUNSMANN S， HOPPE J， KLOPFLEISCH R， et al. Acute interstitial pneumonia in foals： A severe， multifactorial syndrome with lung tissue recovery in surviving foals［J］. Equine Vet J，2021，53（4）：718-726. doi:10.1111/evj.13355 |
| 3 | LONG M E， MALLAMPALLI R K， HOROWITZ J C. Pathogenesis of pneumonia and acute lung injury［J］. Clin Sci （Lond），2022，36（10）：747-769. doi:10.1042/cs20210879 |
| 4 | IONESCU M D， BALGRADEAN M， FILIP C， et al. The role of lung ultrasonography in predicting the clinical outcome of complicated community-acquired pneumonia in hospitalized children［J］. Med Ultrason， 2022，24（1）：19-26. doi:10.11152/mu-3124 |
| 5 | FATOBA A J， MAHARAJ L， ADELEKE V T， et al. Immunoinformatics prediction of overlapping CD8+ T-cell， IFN-γ and IL-4 inducer CD4+ T-cell and linear B-cell epitopes based vaccines against COVID-19 （SARS-CoV-2）［J］. Vaccine， 2021，39（7）：1111-1121. doi:10.1016/j.vaccine.2021.01.003 |
| 6 | ROJAS A， SCHNEIDER I， LINDNER C， et al. Receptor for advanced glycation end-products axis and coronavirus disease 2019 in inflammatory bowel diseases： A dangerous liaison？［J］. World J Gastroenterol， 2021，27（19）：2270-2280. doi:10.3748/wjg.v27.i19.2270 |
| 7 | LEE H， LEE H H， LIM C Y， et al. The utility of high-mobility group A2 overexpression for predicting the prognosis of gastric cancer patients and its contribution to poor prognosis via chemoresistance and the propensity for the occurrence of carcinomatosis peritonei［J］. Surgery，2021，169（5）：1213-1220. doi:10.1016/j.surg.2020.11.020 |
| 8 | 中华医学会儿科分会呼吸学组，《中华儿科杂志》编辑委员会，儿童社区获得性肺炎管理指南（2013修订）（上） ［J］.中华儿科杂志，2013， 51（10）： 745-752. |
| 9 | 中华医学会儿科分会呼吸学组，《中华儿科杂志》编辑委员会，儿童社区获得性肺炎管理指南（2013修订）（下） ［J］.中华儿科杂志，2013， 51（11）： 856-862. |
| 10 | 中华医学会重症医学分会. 急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南（2006）［J］. 中国实用外科杂志， 2007，28（1）：19-28. doi:10.3321/j.issn:1005-2208.2007.01.001 |
| 11 | JUNG H Y， JEON Y， JEON S， et al. Superiority of Simplified Acute Physiologic Score II Compared with Acute Physiologic and Chronic Health Evaluation II and Sequential Organ Failure Assessment Scores for Predicting 48-Hour Mortality in Patients Receiving Continuous Kidney Replacement Therapy［J］. Nephron， 2022，146（4）：369-376. doi:10.1159/000521495 |
| 12 | BODIEN Y G， BARRA A， TEMKIN N R， et al. Diagnosing Level of Consciousness： The Limits of the Glasgow Coma Scale Total Score［J］. J Neurotrauma， 2021，38（23）：3295-3305. |
| 13 | SAGUIL A， FARGO M V. Acute Respiratory Distress Syndrome： Diagnosis and Management［J］. Am Fam Physician， 2020，101（12）：730-738. |
| 14 | ALHUMAID S， MUTARED K M AL， ALAWI Z AL， et al. Severity of SARS-CoV-2 infection in children with inborn errors of immunity （primary immunodeficiencies）： a systematic review［J］. Allergy Asthma Clin Immunol， 2023，19（1）：69. doi:10.1186/s13223-023-00831-1 |
| 15 | LUYT C E， BOUADMA L， MORRIS A C， et al. Pulmonary infections complicating ARDS［J］. Intensive Care Med， 2020，46（12）：2168-2183. doi:10.1007/s00134-020-06292-z |
| 16 | XU B， LIU X， GAO S. IL2-inducible T-cell kinase inhibitor ibrutinib reduces symptoms and Th2 differentiation in mouse allergic-rhinitis model［J］. Drug Dev Res， 2022，83（2）：544-551. doi:10.1002/ddr.21884 |
| 17 | BLA VER?OSA， MUNIZ-JUNQUEIRA M I， MENEZES-SOUZA D， et al. MCP-1/IL-12 ratio expressions correlated with adventitial collagen depositions in renal vessels and IL-4/IFN-γ expression correlated with interstitial collagen depositions in the kidneys of dogs with canine leishmaniasis［J］. Mol Immunol， 2023，156（3）：61-76. doi:10.1016/j.molimm.2023.02.010 |
| 18 | KOTSIOU O S， JAGIRDAR R M， PAPAZOGLOU E D， et al. HΜGB1/sRAGE levels differ significantly between transudates and exudates［J］. Cytokine， 2021，141（4）：155469. doi:10.1016/j.cyto.2021.155469 |
| 19 | 程茹，张素霞. 基于高迁移率族蛋白1/外泌体转录活化因子3途径探讨抗结核药吡嗪酰胺肝损伤的机制［J］. 实用医学杂志， 2023，39（10）：1224-1231. doi:10.3969/j.issn.1006-5725.2023.10.006 |
| 20 | 郑强，唐勇，周程继，等. 乳果糖对失血性休克大鼠急性肺损伤的作用及机制［J］. 实用医学杂志， 2022，38（5）：577-582. doi:10.3969/j.issn.1006?5725.2022.05.011 |
| 21 | ENTEZARI M， JAVDAN M， ANTOINE D J， et al. Inhibition of extracellular HMGB1 attenuates hyperoxia-induced inflammatory acute lung injury［J］. Redox Biol， 2014，20（2）：314-322. |
| 22 | ZHAO H， CHEN H， XIAOYIN M， et al. Autophagy Activation Improves Lung Injury and Inflammation in Sepsis［J］. Inflammation， 2019，42（2）：426-439. doi:10.1007/s10753-018-00952-5 |
/
| 〈 |
|
〉 |