Objective: To investigate the serum levels of microRNA-155 (miR-155) and interleukin-6 (IL-6) in uremic dialysis patients and to evaluate the effect of alprostadil (A) on them.
Methods: A total of 81 chronic kidney disease (CKD) uremic patients were divided into 4 groups: the peritoneal dialysis group (PD group, n=20), the peritoneal dialysis plus alprostadil group (PD+A group, n=20), the hemodialysis group (HD group, n=21), the hemodialysis plus alprostadil group (HD+A group, n=20). Sixteen healthy people were taken as the normal control (NC) group. The peripheral blood of all objects were collected for serum preparation. The expression of miRNA-155 was determined by real-time qPCR and the serum level of IL-6 was measured by ELISA. Experimental and clinical data of all the objects were collected.
Results: Serum levels of miRNA-155 and IL-6 were increased in all dialysis patients groups compared with NC group (P<0.05); miRNA-155 expression in PD+A group was down-regulated compared with PD group or HD group (P<0.05); the levels of IL-6 in PD+A and HD+A group were significantly decreased compared with PD group or HD group (P<0.05). Correlation analysis showed that serum level of miR-155 was positively correlated with the level of IL-6 as well as high-sensitivity C-reactive protein (hs-CRP), while miR-155 was negatively correlated with HDL and albumin (P<0.01). Linear stepwise regression analysis indicated that serum miR-155 was independently associated with albumin and hs-CRP.
Conclusion: Serum miRNA-155 and IL-6 in uremic dialysis patients were remarkably increased compared to healthy objects. Serum miRNA-155 was positively correlated with the level of IL-6 as well as hs-CRP, while miR-155 was negatively correlated with HDL and albumin. Alprostadil could ameliorate the inflammatory conditions of uremic dialysis patients by inhibition of the IL-6 expression. Serum miRNA-155 may be a novel target for the treatment of uremic dialysis patients.
目的：观察尿毒症透析患者外周血血清microRNA-155(miR-155)的表达水平及前列地尔(alprostadil，A)对其的影响，探讨miR-155在尿毒症透析患者炎症状态中的临床意义。方法：按研究标准纳入慢性肾脏病尿毒症患者81例，其中腹膜透析组(PD组)20例，腹膜透析+前列地尔治疗组(PD+A组)20例，维持性血液透析组(HD组)21例，维持性血液透析+前列地尔治疗组(HD+A组)20例，另设健康人群对照组(NC组)16例。采集各观察对象外周血并提取血清，采用实时荧光定量PCR技术检测血清中miR-155的表达水平，ELISA检测血清IL-6水平。收集各观察对象的一般临床资料并检测血脂、血红蛋白、白蛋白、超敏C-反应蛋白、血清铁蛋白等血液生化指标。结果：4组透析患者血清miR-155及IL-6水平均显著高于NC组(P<0.05)；PD+A组miR-155水平较PD组或HD组显著下调(P<0.05)，PD+A组及HD+A组血清IL-6水平均低于PD组或HD组(P<0.05)。相关分析显示：血清miR-155水平与炎症因子IL-6水平呈显著正相关(P<0.01)；同时，血清miR-155水平与超敏C-反应蛋白水平呈正相关，而与HDL及白蛋白水平呈负相关(P<0.01)；血清白蛋白与miR-155呈独立负相关，超敏C-反应蛋白与miR-155呈独立正相关。结论：尿毒症患者外周血清miR-155和IL-6表达水平明显上调；前列地尔可能通过抑制IL-6表达改善尿毒症透析患者炎症状态；血清miR-155有可能成为尿毒症透析患者炎症状态早期诊断及干预的新靶点。.