Proinflammatory versus anti-inflammatory response in sepsis patients: looking at the cytokines

MALAT1 modulates miR-146's protection of microvascular endothelial cells against LPS-induced NF-κB activation and inflammatory injury

To investigate the role of miR-146 and its possible relationship with MALAT1 in LPS-induced inflammation in human microvascular endothelial cells (HMECs), HMEC-1 cells were treated with LPS to construct an inflammatory injury cell model, and the cell viability, TNF-α and IL-6 secretion and the expression levels of VCAM-1, SELE and ICAM-1 were analysed as markers of inflammatory injury. The regulation mechanisms of miR-146 interacted with MALAT1 and the downstream NF-κB signalling were also verified by dual-luciferase assay and knockdown technology. LPS significantly decreased the cell viability, increased levels of VCAM-1, SELE and ICAM-1 and also up-regulated miR-146a/b, TNF-α and IL-6 in a dose-dependent manner. Over-expression of miR-146a resulted in down-regulation of TNF-α and IL-6, as well as VCAM-1, SELE and ICAM-1, while inhibition of miR-146a led to opposite results. The dual-luciferase reporter assay showed both miR-146a and miR-146b directly targeted and negatively regulated the expression of MALAT1. Silencing of MALAT1 suppressed LPS-induced NF-κB activation and TNF-α and IL-6 secretion, reducing the cell inflammatory injury, but these changes were reversed after combined treatment with miR-146a inhibitor. Taken together, we demonstrate that miR-146 protects HMECs against inflammatory injury by inhibiting NF-κB activation. This process is modulated by MALAT1.

Research on the effect of cytokine concentration on the immune level and survival conditions of elderly patients with sepsis

The present study was carried out to investigate the effect of cytokine (CK) concentrations on the immune phenotype and survival conditions of elderly patients with sepsis. A total of 112 elderly patients with sepsis who were admitted to The Affiliated Hospital of Medical School, Ningbo University for treatment between June 2015 and June 2017 were enrolled as the subjects. According to each patient's condition, they were divided into the mild sepsis group (n=68) and the severe sepsis group (n=44). Additionally, a further 60 patients without sepsis who were admitted to the Intensive Care Unit (ICU) of this hospital during the same period were recruited as the control group. The levels of CK, tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-8, procalcitonin (PCT), endothelin-1 (ET-1) and IL-10 were detected, and the assessment system for immune levels was established. The levels of TNF-α, IL-6, IL-8, PCT, ET-1 and IL-10 in the serum of patients in the mild and severe sepsis groups were significantly higher than those in the control group (P<0.05), and the levels in the severe sepsis group were significantly higher than those in the mild sepsis group (P<0.05). Among the 112 sepsis patients, there were 30 mortalities (26.79%) within 30 days, of which the levels of TNF-α, IL-6, IL-8, PCT, ET-1 and IL-10 were significantly higher than those in the surviving patients (P<0.05). Between the mild and severe sepsis groups, as well as the number of mortalities and surviving patients, there were statistically significant differences when comparing the immunological phenotypes (P<0.05). These findings indicated that the levels of TNF-α, IL-6, IL-8, PCT, ET-1 and IL-10 were associated with the condition and prognosis of elderly patients with sepsis, and the assessment system for immune levels based on the levels of these indicators was conducive to the stipulation of individualized immune regulation procedure and prognostic evaluation of sepsis.