Free Radic Biol Med:肺炎重症患者的循环蛋白羰基特异性升高

2021-11-26 MedSci原创 MedSci原创

感染性休克是一种对严重感染的危及生命的失调反应,与氧化应激升高相关。蛋白质羰基的产生是蛋白质分子被自由基氧化修饰的一个重要标记。

感染性休克是一种对严重感染的危及生命的失调反应,与氧化应激升高相关。蛋白质羰基的产生是蛋白质分子被自由基氧化修饰的一个重要标记。本篇文章旨在评估不同来源脓毒症重症患者的蛋白质羰基,并确定维生素C干预对蛋白质羰基浓度的影响。

实验方法:

招募感染性休克重症患者(n = 40),记录脓毒症来源和ICU严重程度评分。患者随机接受静脉维生素C(100 mg/kg体重/天)或安慰剂输注。在基线和之后每天采集血样,持续3天,血样用于测量细胞计数、维生素C浓度、蛋白质羰基、C反应蛋白和髓过氧化物酶浓度。

实验结果:

图1: 在研究期间,脓毒症患者的中位血浆蛋白羰基浓度增加了2.2倍(从169[137,255]pmol/mg蛋白增加到369[176,550]pmol/mg蛋白),相当于每天增加43(95%CI 19~66)pmol/mg蛋白(p < 0.001).基线时总队列中蛋白羰基浓度与APACHE III(r = 0.47,p = 0.002)和SOFA评分(r = 0.371,p = 0.02)显著相关。蛋白质羰基浓度与SAPS或氧合之间无相关性(PaO2/FiO2;p > 0.05)。

图2:在研究入院时,肺炎重症患者的蛋白质羰基(435 pmol/mg蛋白质)相对于其他来源脓毒症患者(157 pmol/mg蛋白质,p < 0.0001;图2A)显著升高。

在整个队列中,这些炎症参数与蛋白羰基浓度无关(p > 0.05)。在肺炎患者中(正方形标记),蛋白质羰基浓度随时间变化相对稳定(图2B)。相比之下,在其他脓毒症患者中(圆形标记),蛋白质羰基浓度估计增加了49 (95% CI 23至75)pmol/mg蛋白质/天(p < 0.001),尽管这些值在72小时仍显著低于肺炎患者(p =0.004)。

图3:基线时,总队列的平均维生素C状态在缺乏范围内(9.8±1.4 μmol/L)。基线时血浆维生素C和蛋白质羰基浓度之间无相关性(p > 0.88)。患者随机接受安慰剂输注或静脉注射维生素C(100 mg/kg/天),干预组在3天研究期间导致平均维生素C血浆浓度显著升高,分别为285±34 μmol/L、374±68 μmol/L和456±90 μmol/L。随着时间的推移,安慰剂组(圆形标记)和干预组(正方形标记)的蛋白质羰基均显著增加(p = 0.015;图3).两组之间无显著差异(p = 0.8)。因此,静脉给予维生素C不会减弱蛋白质羰基浓度的增加。

结论:这是首次评估静脉注射维生素C干预对感染性休克重症患者氧化应激标志物影响的试验。尽管与安慰剂相比,我们没有观察到干预对蛋白质羰基浓度的任何影响,但在肺炎患者中观察到的蛋白质羰基浓度升高在进入研究时已经很明显,并且可能发生在休克之前。目前尚不清楚肺炎患者相对于其他来源败血症患者蛋白质羰基浓度升高的原因,可能表明败血症肺部来源的特异性机制。

原文链接:https://pubmed.ncbi.nlm.nih.gov/34818575/

Circulating protein carbonyls are specifically elevated in critically ill patients with pneumonia relative to other sources of sepsis

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    2022-04-29 jeanqiuqiu
  4. [GetPortalCommentsPageByObjectIdResponse(id=1899524, encodeId=cd4a189952411, content=<a href='/topic/show?id=6f746e94170' target=_blank style='color:#2F92EE;'>#特异性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67941, encryptionId=6f746e94170, topicName=特异性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, createdName=jinweidong, createdTime=Mon Dec 20 02:33:21 CST 2021, time=2021-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767881, encodeId=f1b71e67881e8, content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Thu Mar 24 09:33:21 CST 2022, time=2022-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1859208, encodeId=522218592081b, content=<a href='/topic/show?id=e0a9593596' target=_blank style='color:#2F92EE;'>#DIC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5935, encryptionId=e0a9593596, topicName=DIC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Fri Apr 29 21:33:21 CST 2022, time=2022-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1919347, encodeId=2fbc191934e3e, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Wed Sep 14 07:33:21 CST 2022, time=2022-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1706285, encodeId=a3b11e06285af, content=<a href='/topic/show?id=e6f450461fd' target=_blank style='color:#2F92EE;'>#循环蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50461, encryptionId=e6f450461fd, topicName=循环蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffd131196023, createdName=1249842em19(暂无昵称), createdTime=Tue Mar 08 06:33:21 CST 2022, time=2022-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284125, encodeId=376312841253a, content=<a href='/topic/show?id=cdb79594643' target=_blank style='color:#2F92EE;'>#重症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95946, encryptionId=cdb79594643, topicName=重症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Sun Nov 28 03:33:21 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611346, encodeId=f6751611346dc, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Nov 28 03:33:21 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074319, encodeId=f44d10e4319d3, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4d32010516, createdName=1e1ebb68m12(暂无匿称), createdTime=Fri Nov 26 20:04:37 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
    2022-09-14 sunylz
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