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Background Sarcoidosis is a granulomatous multisystem disease of uncertain aetiology. The disease has major inflammatory and immune components; however, the immunopathogenesis is not well understood. Micro ribonucleic acids (microRNAs) are classes of miniature, single-stranded, non-coding RNAs. Their key recognised role includes mediating the silencing of target genes post-transcriptionally. Recently, the role of miRNAs has gained interest in numerous disorders, suggested as being involved in pathogenesis of those diseases and acting as disease markers. Very little is known about the role of miRNAs in sarcoidosis, with nothing known regarding miRNAs in South African patients. The main objective, therefore, was to investigate the serum expression of approximately 800 miRNAs in patients with sarcoidosis compared with race-, age- and gender-matched healthy controls. Methods A total of six patients and six matched controls participated in this study. Whole blood samples were collected in EDTA tubes, processed and the plasma retained. RNA was extracted from the stored plasma samples using the QIAGEN miRNeasy Mini Kit® and concentrated using a salt-ethanol precipitation. The extracted miRNA was profiled using an nCounter® miRNA human v3 expression assay and data analysed using the nSolver™ Analysis Software. Results After excluding one sample/control pair because of cellular RNA contamination, the remaining five patient and five matched control samples were analysed, and 145 miRNAs were found to be potentially differentially expressed. On applying a Bonferroni correction, the only miRNA that was significantly different was miRNA let-7a-5p, which was significantly overexpressed (141-fold change; p<0.0003) in patients compared with controls. Conclusion This is the first miRNA report of differentially expressed miRNAs in the serum of patients with sarcoidosis and matched healthy controls in South Africa. The results obtained suggest that miRNAs may play a role in sarcoidosis pathogenesis. Whether these molecules have diagnostic or prognostic implications, needs future studies recruiting larger patient cohorts.
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Despite advances in diagnosis; surgery; antimicrobial therapy and intensive care support; the mortality rate associated with intra-abdominal sepsis remains unacceptably high. The aim of the present study was to identify prognostic factors in 54 consecutive cases with abdominal sepsis admitted to the intensive care unit (ICU) over a two-year period; from January 2001 to December 2002. This was a retrospective record review of cases with abdominal sepsis admitted to the ICU. Of 54 patients that were studied; only 14 survived. The mortality rate was 74.1. Non-survivors had significantly longer ICU stay; had more relook laparotomies; more blood transfusions and a significantly higher APACHE II score on admission to the ICU. Other results revealed that non-survivors required significantly more inotropic support and corticosteroids; had a lower paO2/FiO2 ratio and had more total arenteral nutrition days. None of the patients who urvived required dialysis. The number of relook laparotomies were higher in the non-survivors and the maximum number of relook laparotomies were four in the survivors and 13 in the non-survivors. The non-survivors were also more likely to have an open abdomen. We conclude that patients with abdominal sepsis have an extremely high mortality and utilise an enormous amount of limited intensive care resources. The length of ICU stay; APACHE II score on admission; number of relook laparotomies; whether the abdomen was left open or not; and requirement for inotropic support; dialysis; total parenteral nutrition and blood transfusions were predictive of adverse outcomes in these patients
