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| Effect of glucocorticoid on inflammatory cytokines and miRNA-122a in septic shock |
| Sang Zhen-zhen, Gao Jie, Jia Chun-mei, Li Yong |
| Department of Emergency, Cangzhou Central Hospital, Cangzhou 061000, China |
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Abstract Objective To observe the effect of hydrocortisone on inflammatory cytokines and miRNA-122a in patients with septic shock. Methods Total of 125 septic shock patients admitted to the emergency intensive care unit (EICU) of Cangzhou central hospital from Dec. 2016 to Dec. 2018 were divided into two groups: conventional treatment group (65 cases), Hydrocortisone treatment group (60 cases).The conventional treatment group received basic treatment, while the Hydrocortisone treatment group on the basis comprehensive treatment were given intravenous infusion of hydrocortisone (200 mg, every day) for consecutive 7 days. The serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), High mobility family protein B-1 (HMGB-1) were determined by enzyme-linked immunosorbent (ELISA) before and after 3 and 7d of treatment. The expression level of serum miRNA-122a was detected by real-time PCR. The APACHEⅡ score, SOFA score, liver function, vasoactive drug use time, EICU treatment time and 28d death rate were compared between the two groups. Results Before treatment, there were no significant difference in serum TNF-α, IL-6, HMGB-1 and miRNA-122a levels between the two groups (P>0.05). After treatment, the above indexes were lower than those before treatment, and all indexes in the hydrocortisone treatment group were lower than those in the conventional treatment group［TNF-α(pg/mL): 3 d 146.29±19.34 vs. 165.26±16.45, 7 d 118.63±20.48 vs. 125.83±16.87; IL-6(pg/mL): 3 d 150.73±15.36 vs. 237.62±18.45, 7 d 124.35±16.28 vs. 149.94±19.64；HMGB-1(ng/mL): 3 d 7.78±1.06 vs. 11.72±1.25, 7 d 2.49±0.50 vs. 3.87±0.64；miRNA-122a: 3 d 1.42±0.46 vs. 1.95±0.37, 7 d 0.86±0.15 vs. 1.18±0.29；P<0.01］. Compared with the conventional treatment group, the liver function improved obviously［ALT(U/L): 3 d 77(120.3) vs. 72.8(112.4), 7 d 69(28.2) vs. 62.5(20.9)；AST(U/L): 3 d 80.4(118.5) vs. 76.7(105.8), 7 d 73.6(29.7) vs. 65.9(26.7)；TBIL(mg/dL): 3 d 1.7(3.4) vs. 1.6(2.7), 7 d 1.5(0.9) vs. 1.4(0.8)；P<0.01］, and EICU treatment time(d：15.4±6.5 vs. 10.7±5.3)were significantly shortened, and the differences were statistically significant (P<0.05). However, there was no statistically significant difference in the 28-day mortality between the two groups (P>0.05). Conclusion Hydrogenation can significantly reduce the expression level of serum miRNA-122a of patients with septic shock and reduce the levels of inflammatory cytokines, thus reducing liver injury and shortening the treatment time of EICU, but it cannot reduce the 28-day mortality of patients with septic shock.
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Corresponding Authors:
Li Yong, E-mail: sangzhenzhen@163.com
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