Predictive value of SIRT2 in the progression of sepsis to persistent inflammation-immunosuppression and catabolism syndrome / 中华急诊医学杂志

ABSTRACT

Objective:To explore the predictive value of SIRT2 in the progression of sepsis to persistent inflammation-immunosuppression and catabolism syndrome (PICS).Methods:From June 2018 to June 2019, 81 sepsis patients in Intensive Care Unit of Tianjin First Center Hospital were enrolled, and 20 healthy adult volunteers were recruited as controls. Forty-five patients who had been hospitalized for more than 14 d were selected and divided into the non-PICS group and PICS group. Blood samples were collected at 0, 24 h, 4 d, 7 d, 10 d, 14 d, 17 d, and 21 d. The levels of SIRT2, PD-1, TNF-α, IL-6, IL-10 and TGF-β were measured at different time points. In the control group, and fasting was taken only once in the morning. ROC curve was drawn and AUC was calculated to evaluate the value of SIRT2 and PD-1 in predicting sepsis progression to PICS.Results:(1) Compared with the control group, the expression of SIRT2 and PD-1 decreased at admission in the non-PICS group and PICS group ( P<0.05). Compared with the non-PICS group, the expression of SIRT2 and PD-1 in the PICS group increased at 10 and 14 d, respectively. SIRT2 in the PICS group had statistical difference at 10 d [(0.87±0.08) and (1.15±0.09), respectively; P<0.05]. PD-1 was statistical difference at 14 d between the two groups[ (0.86±0.04 )and (1.01±0.02), respectively; P<0.05]. (2) Over time, TNF-α and IL-6 in the two groups declined gradually, but IL-10 and TGF-β in the PICS group were higher than those in the non-PICS group at 10 d ( P<0.05). (3) The AUC of PD-1 was 0.766 (95% CI 0.624-0.908), and the sensitivity and specificity were 70.8% and 81.0%, when the cut-off value was 1.01. The AUC of SIRT 2 was 0.841 (95% CI 0.722-0.960), and the sensitivity and specificity were 79.2% and 81.0%, when the cut-off value was 1.10. Conclusions:SIRT2 expression level changes when sepsis patients enter PICS stage. SIRT2 has certain predictive value for the occurrence of PICS.