This study aimed to investigate the clinical significance of serum microRNA-219-5p (miR-219-5p) in patients with multiple organ dysfunction syndrome (MODS) caused by acute paraquat (PQ) poisoning, and its correlation with Toll-like Receptor 4 (TLR4). Luciferase reporter assay was used to investigate in vitro the correlation of miR-219-5p with TLR4. Serum miR-219-5p levels were evaluated by quantitative real-time polymerase chain reaction. Serum levels of TLR4, IL-1β, and TNF-α were measured by Enzyme-linked immune sorbent assay (ELISA). ROC analysis was performed to assess the diagnostic significance, Kaplan-Meier survival curves and Cox regression analysis were used to evaluate the prognostic value of miR-219-5p in MODS patients. TLR4 was a target gene of miR-219-5p and was increased in MODS patients. Serum miR-219-5p level was decreased and negatively correlated with TLR4 level in MODS patients (r = −0.660, P < 0.001), which had important diagnostic value and negatively correlated with APACHE II score in MODS patients. The miR-219-5p expression was markedly associated with the WBC, ALT, AST, PaCO₂, Lac, and APACHE II score. Non-survivals had more patients with low miR-219-5p expression. Patients with low miR-219-5p expression had shorter survival time. MiR-219-5p and APACHE II score were two independently prognostic factors for 28-day survival. MiR-219-5p was negatively correlated with, while TLR4 was positively correlated with the levels of IL-1β and TNF-α. The serum miR-219-5p level may be a potential biomarker for acute PQ-induced MODS diagnosis and prognosis. Furthermore, miR-219-5p may be associated with the progression of MODS by regulating TLR4-related inflammatory response.

本研究旨在探讨血清microRNA-219-5p（miR-219-5p）对急性百草枯（PQ）中毒所致多器官功能障碍综合征（MODS）患者的临床意义及其与Toll样受体4的相关性。 (TLR4)。荧光素酶报告基因检测用于体外研究 miR-219-5p 与 TLR4 的相关性。通过定量实时聚合酶链反应评估血清 miR-219-5p 水平。通过酶联免疫吸附测定 (ELISA) 测量 TLR4、IL-1β 和 TNF-α 的血清水平。进行ROC分析以评估诊断意义，Kaplan-Meier生存曲线和Cox回归分析用于评估miR-219-5p在MODS患者中的预后价值。TLR4 是 miR-219-5p 的靶基因，在 MODS 患者中升高。r = -0.660, P < 0.001)，具有重要的诊断价值，与 MODS 患者的 APACHE II 评分呈负相关。miR-219-5p 表达与 WBC、ALT、AST、PaCO ₂显着相关、Lac 和 APACHE II 评分。未存活的患者有更多的 miR-219-5p 低表达患者。miR-219-5p 表达低的患者存活时间较短。MiR-219-5p 和 APACHE II 评分是 28 天生存率的两个独立预后因素。MiR-219-5p 与 IL-1β 和 TNF-α 水平呈负相关，而 TLR4 与 IL-1β 和 TNF-α 水平呈正相关。血清 miR-219-5p 水平可能是急性 PQ 诱导的 MODS 诊断和预后的潜在生物标志物。此外，miR-219-5p 可能通过调节 TLR4 相关炎症反应与 MODS 的进展相关。