Background: Recent research highlighted the potential role of circulating cell-free DNA (cfDNA), resulted by apoptosis or cell necrosis, as a prognostic marker in the setting of different clinical conditions. Cardiorenal syndrome type 1 (CRS type 1) is characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). Apoptosis of renal epithelial cells is proposed as a mechanism involved in CRS type 1. In this study, we investigated cfDNA levels in patients with acute heart failure (AHF) and CRS type 1 and the possible correlation between cfDNA levels and inflammatory and apoptotic parameters. Methods: We enrolled 17 AHF patients and 15 CRS type 1 who exhibited AKI at the time of admission (caused by AHF) or developed AKI during the first 48 h from admission. cfDNA was extracted from plasma and quantified by real-time polymerase chain reaction. Plasma levels of NGAL, tumor necrosis factor-α, interleukin (IL)-6, IL-18, and caspase-3 were measured. Results: We observed significantly higher levels of cfDNA in patients with CRS type 1 than patients with AHF. Caspase-3, IL-6, IL-18, and NGAL levels resulted significantly increased in patients with CRS type 1. Moreover, a positive correlation between cfDNA levels and caspase-3 levels was found, as well as between cfDNA levels and IL-6 and renal parameters. Conclusion: Our study explores the premise of cfDNA as a marker for apoptosis and inflammation in CRS type 1 patients. cfDNA could potentially serve as an index for noninvasive monitoring of tissue damage and apoptosis in patients with AKI induced by AHF.
Cardiorenal Med

中文翻译：

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无细胞血浆 DNA 在 1 型心肾综合征患者中的作用

背景：最近的研究强调了由细胞凋亡或细胞坏死导致的循环无细胞 DNA (cfDNA) 作为不同临床条件下的预后标志物的潜在作用。1 型心肾综合征（CRS 1 型）的特征是心脏功能迅速恶化，导致急性肾损伤 (AKI)。肾上皮细胞凋亡被认为是 1 型 CRS 的一种机制。在本研究中，我们调查了急性心力衰竭 (AHF) 和 1 型 CRS 患者的 cfDNA 水平，以及 cfDNA 水平与炎症和凋亡参数之间可能的相关性。方法：我们招募了 17 名 AHF 患者和 15 名 CRS 1 型患者，他们在入院时表现出 AKI（由 AHF 引起）或在入院后的前 48 小时内出现 AKI。从血浆中提取 cfDNA 并通过实时聚合酶链反应进行定量。测量了 NGAL、肿瘤坏死因子-α、白细胞介素 (IL)-6、IL-18 和 caspase-3 的血浆水平。结果：我们观察到 CRS 1 型患者的 cfDNA 水平显着高于 AHF 患者。1 型 CRS 患者的 Caspase-3、IL-6、IL-18 和 NGAL 水平显着升高。此外，发现 cfDNA 水平与 caspase-3 水平以及 cfDNA 水平与 IL- 6、肾参数。结论：我们的研究探索了 cfDNA 作为 CRS 1 型患者细胞凋亡和炎症标志物的前提。cfDNA 可能作为无创监测 AHF 诱导的 AKI 患者组织损伤和细胞凋亡的指标。
心肾医学