自噬蛋白Beclin1及炎症因子表达在脓毒症急性肾损伤中的作用

doi:10.3877/cma.j.issn.1674-6880.2020.06.001

目的

探讨自噬蛋白Beclin1及炎症因子表达在脓毒症急性肾损伤（AKI）中的作用。

方法

选择2017年1月至2019年6月南京医科大学附属南京医院ICU收治的86例脓毒症患者，根据患者入ICU时是否合并AKI，将86例患者分成AKI组（33例）和非AKI组（53例）。记录所有患者入ICU时血清胱抑素C、肿瘤坏死因子、干扰素、白细胞介素6（IL-6）、IL-10以及入ICU时和第7天外周静脉血自噬蛋白Beclin1及P62的表达水平。采用Pearson相关分析脓毒症患者自噬蛋白Beclin1与胱抑素C、IL-6的相关性。

结果

AKI组脓毒症患者入ICU时和第7天Beclin1蛋白水平均较同时间点非AKI组显著升高（t = 5.213、7.144，P = 0.007、0.002），P62蛋白水平均较同时间点非AKI组显著降低（t = 4.618、7.223，P = 0.025、0.003）；AKI组患者第7天Beclin1蛋白水平较入ICU时显著升高（t = 4.865，P = 0.006），而P62蛋白水平较入ICU时显著降低（t = 5.996，P = 0.006）。AKI组患者入ICU时血清胱抑素C [（2.4 ± 0.5）mg / L vs.（1.3 ± 0.4）mg / L]及IL-6 [（613 ± 163）ng / L vs.（269 ± 124）ng / L]表达水平均显著高于非AKI组患者（t = 10.459、11.068，P均< 0.001）。Pearson相关分析结果显示，脓毒症患者自噬蛋白Beclin1表达水平与血清胱抑素C（r = 0.949，P = 0.001）、IL-6（r = 0.824，P = 0.012）均呈正相关。

结论

脓毒症患者发生AKI与自噬蛋白Beclin1及炎症因子异常表达有关。

关键词: 脓毒症, 急性肾损伤, 自噬, 炎症因子

Objective

To investigate the role of autophagy protein Beclin1 and inflammatory factors in patients with sepsis and acute kidney injury (AKI).

Methods

A total of 86 patients with sepsis admitted to the ICU of Nanjing First Hospital, Nanjing Medical University from January 2017 to June 2019 were divided into an AKI group (n = 33) and a non-AKI group (n = 53) according to whether they were combined with AKI at ICU admission. The serum cystatin C, tumor necrosis factor, interferon, interleukin-6 (IL-6) and IL-10 at ICU admission and the expression levels of autophagy protein Beclin1 and P62 in peripheral venous blood at the time of ICU admission and 7th day were recorded for all patients. Pearson correlation was used to analyze the correlation of Beclin1 with cystatin C and IL-6 in septic patients.

Results

The Beclin1 protein levels were significantly higher (t = 5.213, 7.144; P = 0.007, 0.002) and the P62 protein levels were significantly lower (t = 4.618, 7.223; P = 0.025, 0.003) in the AKI group than in the non-AKI group both at the time of ICU admission and 7th day. In the AKI group, the Beclin1 protein level was significantly higher (t = 4.865, P = 0.006) and the P62 protein level was significantly lower (t = 5.996, P = 0.006) at the 7th day than at ICU admission. The expression levels of cystatin C [(2.4 ± 0.5) mg / L vs. (1.3 ± 0.4) mg / L] and IL-6 [(613 ± 163) ng / L vs. (269 ± 124) ng / L] were significantly higher in the AKI group than in the non-AKI group at ICU admission (t = 10.459, 11.068; both P < 0.001). Pearson correlation analysis showed that the Beclin1 level of patients with sepsis was positively correlated with cystatin C (r = 0.949, P = 0.001) and IL-6 (r = 0.824, P = 0.012).

Conclusion

The occurrence of AKI in patients with sepsis is associated with abnormal expression levels of autophagy protein Beclin1 and inflammatory factors.

Key words: Sepsis, Acute kidney injury, Autophagy, Inflammatory factors

图1 脓毒症AKI与非AKI患者血Beclin1及P62蛋白表达水平的比较

表1 两组脓毒症患者入ICU时血清胱抑素C与炎症因子含量的比较（±s）

组别	例数	胱抑素C（mg / L）	TNF（ng / L）	干扰素（ng / L）	IL-6（ng / L）	IL-10（ng / L）
AKI组	33	2.4 ± 0.5	3.9 ± 3.2	4.2 ± 3.3	613 ± 163	31 ± 25
非AKI组	53	1.3 ± 0.4	3.1 ± 3.0	3.7 ± 2.5	269 ± 124	29 ± 22
t值		10.459	0.832	0.763	11.068	0.793
P值		< 0.001	0.612	0.714	< 0.001	0.847

表1 两组脓毒症患者入ICU时血清胱抑素C与炎症因子含量的比较（±s）

组别	例数	胱抑素C（mg / L）	TNF（ng / L）	干扰素（ng / L）	IL-6（ng / L）	IL-10（ng / L）
AKI组	33	2.4 ± 0.5	3.9 ± 3.2	4.2 ± 3.3	613 ± 163	31 ± 25
非AKI组	53	1.3 ± 0.4	3.1 ± 3.0	3.7 ± 2.5	269 ± 124	29 ± 22
t值		10.459	0.832	0.763	11.068	0.793
P值		< 0.001	0.612	0.714	< 0.001	0.847

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Role of autophagy protein Beclin1 and inflammatory factors in sepsis with acute kidney injury

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Role of autophagy protein Beclin1 and inflammatory factors in sepsis with acute kidney injury