Abstract

Although soluble urokinase plasminogen activator receptor (suPAR), T helper (Th)-1 and Th17 cells are separately reported to be dysregulated and correlate with disease severity in several infection-mediated diseases, fewer studies report their interaction and clinical value in sepsis management. Thus, this study aimed to investigate the correlation of blood suPAR with Th1 and Th17 cell proportion, as well as their diagnostic and prognostic value in elderly sepsis patients. Totally, 223 elderly sepsis patients were recruited. Serum suPAR was detected by enzyme-linked immunosorbent assay. Besides, Th1 and Th17 cell proportion from CD4⁺ T cells were determined by flow cytometry. For sepsis severity evaluation, Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Sequential Organ Failure Assessment (SOFA) score were used. Moreover, survival profile within 28 days was documented. The mean value of suPAR, Th1 cell proportion and Th17 cell proportion was 27.5 ± 15.1 ng/mL, 15.3 ± 4.3% and 4.0 ± 2.3%, respectively. Furthermore, suPAR was positively correlated with Th1 cell proportion, Th17 cell proportion, IFN-γ, IL-17 and TNF-α. Meanwhile, suPAR was positively correlated with APACHE II score and SOFA score, so did Th17 cell proportion. Regarding their prognostic value, suPAR and Th17 cell proportion were superior to differ survivors from deaths than Th1 cell proportion. SuPAR positively correlates with Th1, Th17 cell proportion; and they correlate with increased disease severity and mortality risk in elderly sepsis patients.

摘要

尽管可溶性尿激酶纤溶酶原激活物受体 (suPAR)、T 辅助 (Th)-1 和 Th17 细胞分别被报道在几种感染介导的疾病中失调并与疾病严重程度相关，但很少有研究报告它们在脓毒症管理中的相互作用和临床价值。因此，本研究旨在探讨血液 suPAR 与 Th1 和 Th17 细胞比例的相关性，以及它们在老年脓毒症患者中的诊断和预后价值。共招募了223名老年脓毒症患者。通过酶联免疫吸附试验检测血清suPAR。^{此外，来自 CD4 +}的 Th1 和 Th17 细胞比例通过流式细胞术测定 T 细胞。对于脓毒症严重程度评估，使用急性生理学和慢性健康评估 (APACHE) II 评分和序贯器官衰竭评估 (SOFA) 评分。此外，记录了 28 天内的生存情况。suPAR、Th1 细胞比例和 Th17 细胞比例的平均值分别为 27.5 ± 15.1 ng/mL、15.3 ± 4.3% 和 4.0 ± 2.3%。此外，suPAR与Th1细胞比例、Th17细胞比例、IFN-γ、IL-17和TNF-α呈正相关。同时，suPAR与APACHE II评分和SOFA评分呈正相关，Th17细胞比例也呈正相关。关于它们的预后价值，suPAR 和 Th17 细胞比例优于不同的死亡幸存者，而不是 Th1 细胞比例。SuPAR与Th1、Th17细胞比例呈正相关；