0.001). Significant prognostic factors for fatality included mechanical ventilation within the first 24 hours (p--.013), mean sequential organ failure assessment (SOFA) score on admission (p--.04), serum lactate (p-lt;-.001), and both plasma nuclear and mitochondrial DNA on admission (p-lt;-.001). Plasma mitochondrial DNA was an independent predictor of fatality by stepwise logistic regression such that an increase by one ng/mL in level would increase fatality rate by 0.7%. Conclusion Plasma DNA has potential use for predicting outcome in septic patients arriving at the emergency room. Plasma mitochondrial DNA level on admission is a more powerful predictor than lactate concentration or SOFA scores on admission." />
Plasma nuclear and mitochondrial DNA levels as predictors of outcome in severe sepsis patients in the emergency room
详细信息    查看全文
  • 作者：Chia-Te Kung (1)
    Sheng-Yuan Hsiao (1)
    Tsung-Cheng Tsai (1)
    Chih-Min Su (1)
    Wen-Neng Chang (2)
    Chi-Ren Huang (2)
    Hung-Chen Wang (3)
    Wei-Che Lin (4)
    Hsueh-Wen Chang (6)
    Yu-Jun Lin (3) (6)
    Ben-Chung Cheng (5) (6)
    Ben Yu-Jih Su (5)
    Nai-Wen Tsai (2) (7)
    Cheng-Hsien Lu (2) (6) (7)
  • 关键词：Hospital mortality ; Mitochondrial DNA ; Nucleus DNA ; Severe sepsis
  • 刊名：Journal of Translational Medicine
  • 出版年：2012
  • 出版时间：December 2012
  • 年：2012
  • 卷：10
  • 期：1
  • 全文大小：248KB
  • 参考文献：1. Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. / N Engl J Med 2003, 348:1546-554. CrossRef
    2. Leon SA, Shapiro B, Sklaroff DM, Yaros MJ: Free DNA in the serum of cancer patients and the effect of therapy. / Cancer Res 1977, 37:646-50.
    3. Jiang N, Pisetsky DS: The effect of inflammation on the generation of plasma DNA from dead and dying cell in the peritoneum. / J Leukoc Biol 2005, 77:1-.
    4. Jahr S, Hentze H, English S, Hardt D, Fackelmayer FO, Hesch RD, Knippers R: DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells. / Cancer Res 2001, 61:1659-665.
    5. Tsumita T, Iwanagam M: Fate of injected deoxyribonucleic acid in mice. / Nature 1963, 198:1088-089. CrossRef
    6. Lo YM, Rainer TH, Chan LY, Hjelm NM, Cocks RA: Plasma DNA as a prognostic marker in trauma patients. / Clin Chem 2000, 46:319-23.
    7. Chang CP, Chia RH, Wu TL, Tsao KC, Sun CF, Wu JT: Elevated cell-free serum DNA detected in patients with myocardial infarction. / Clin Chim Acta 2003, 327:95-01. CrossRef
    8. Rainer TH, Wong LK, Lam W, Yuen E, Lam NY, Metreweli C, Lo YM: Prognostic use of circulating plasma nucleic acid concentrations in patients with acute stroke. / Clin Chem 2003, 49:562-69. CrossRef
    9. Saukkonen K, Lakkisto P, Pettila V, Varpula M, Karlsson S, Ruokonen E, Pulkki K: Cell-free plasma DNA as a predictor of outcome in severe sepsis and septic shock. / Clin Chem 2008, 54:1000-007. CrossRef
    10. Huang CH, Tsai MS, Hsu CY, Chen HW, Wang TD, Chang WT, Ma MH, Chien KL, Chen SC, Chen WJ: Circulating cell-free DNA levels correlate with post-resuscitation survival rates in out-of-hospital cardiac arrest patients. / Resuscitation 2012, 83:213-18. CrossRef
    11. Okkonen M, Lakkisto P, Korhonen AM, Parviai-nen I, Reinikainen M, Varpula T, Pettil? V: Plasma cell-free DNA in patients needing mechanical ventilation. / Crit Care 2011, 15:R196. CrossRef
    12. Hotchkiss RS, Nicholson DW: Apoptosis and caspases regulate death and inflammation in the sepsis. / Nat Rev Immunol 2006, 6:813-22. CrossRef
    13. Martins GA, Kawamura MT, Carvalho Mda G: Detection of DNA in the plasma of septic patients. / Ann NY Acad Sci 2000, 906:134-40. CrossRef
    14. Zeerleder S, Zwart B, Wuillemin WA, Aarden LA, Groeneveld AB, Caliezi C, van Nieuwenhuijze A, van Mierlo GJ, Eerenberg AJ, Lammle B, Hack CE: Elevated nucleosome levels in systemic inflammation and sepsis. / Crit Care Med 2003, 31:1947-951. CrossRef
    15. Rhodes A, Wort SJ, Thomas H, Collinson P, Bennett ED: Plasma DNA concentration as predictor of mortality and sepsis in critically ill patients. / Crit Care 2006, 10:R60. CrossRef
    16. American College of Chest Physicians/Society of Critical Care Medicine Consensus Committee: Definition for sepsis and organ failures and guidelines for the use of innovative therapies in sepsis. / Chest 1992, 101:1658-662.
    17. Lo YM, Tein MS, Lau TK, Haines CJ, Leung TN, Poon PM, Wainscoat JS, Johnson PJ, Chang AM, Hjelm NM: Quantitative analysis of fetal DNA in maternal plasma and serum: implications for non-invasive pre-natal diagnosis. / Am J Hum Genet 1998, 62:768-75. CrossRef
    18. Chiu RW, Chan LY, Lam NY, Tsui NB, Ng EK, Rainer TH, Lo YM: Quantitative analysis of circulating mitochondrial DNA in plasma. / Clin Chem 2003, 49:719-26. CrossRef
    19. Brunelle JK, Chandel NS: Oxygen deprivation induced cell death: an update. / Apoptosis 2002, 7:475-82. CrossRef
    20. Huttunen R, Kuparinen T, Jylhava J: Fatal outcome in bacteremia is characterized by high plasma cell free DNA concentration and apoptotic DNA fragmentation: A prospective cohort study. / PLoS One 2011, 6:e21700. CrossRef
    21. Labbeand K, Saleh M: Cell death in the host response to infection. / Cell Death Differ 2008, 15:1339-349. CrossRef
  • 作者单位：Chia-Te Kung (1)
    Sheng-Yuan Hsiao (1)
    Tsung-Cheng Tsai (1)
    Chih-Min Su (1)
    Wen-Neng Chang (2)
    Chi-Ren Huang (2)
    Hung-Chen Wang (3)
    Wei-Che Lin (4)
    Hsueh-Wen Chang (6)
    Yu-Jun Lin (3) (6)
    Ben-Chung Cheng (5) (6)
    Ben Yu-Jih Su (5)
    Nai-Wen Tsai (2) (7)
    Cheng-Hsien Lu (2) (6) (7)

    1. Department of Emergency Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    2. Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    3. Department of Neurosurgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    4. Department of Radiology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    6. Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
    5. Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    7. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung City, 833, Taiwan
文摘
Background and aim The sensitivity and specificity of biomarkers and scoring systems used for predicting fatality of severe sepsis patients remain unsatisfactory. This study aimed to determine the prognostic value of circulating plasma DNA levels in severe septic patients presenting at the Emergency Department (ED). Methods Sixty-seven consecutive patients with severe sepsis and 33 controls were evaluated. Plasma DNA levels were estimated by real-time quantitative polymerase chain reaction assay using primers for the human β-hemoglobin and ND2 gene. The patients-clinical and laboratory data on admission were analyzed. Results The median plasma nuclear and mitochondria DNA levels for severe septic patients on admission were significantly higher than those of the controls. The mean plasma nuclear DNA level on admission correlated with lactate concentration (γ--.36, p--.003) and plasma mitochondrial DNA on admission (γ--.708, p-lt;-em class="a-plus-plus">0.001). Significant prognostic factors for fatality included mechanical ventilation within the first 24 hours (p--.013), mean sequential organ failure assessment (SOFA) score on admission (p--.04), serum lactate (p-lt;-.001), and both plasma nuclear and mitochondrial DNA on admission (p-lt;-.001). Plasma mitochondrial DNA was an independent predictor of fatality by stepwise logistic regression such that an increase by one ng/mL in level would increase fatality rate by 0.7%. Conclusion Plasma DNA has potential use for predicting outcome in septic patients arriving at the emergency room. Plasma mitochondrial DNA level on admission is a more powerful predictor than lactate concentration or SOFA scores on admission.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址：北京市海淀区学院路29号 邮编：100083

电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700