Clinical Value of Pepsinogen in the Screening, Prevention, and Diagnosis of Gastric Cancer

OBJECTIVES

To compare the levels of serum pepsinogen (PG) in patients with gastric cancer (GC), patients with atrophic gastritis (AG), and healthy donors. Also, we explored the clinical value of PG detection for the diagnosis and treatment of GC.

METHODS

The PG level in peripheral blood from patients and heathy donors was determined using an Abbott automatic chemiluminescence instrument. The study included 117 patients with GC confirmed by gastroscopy and histopathology, of whom 13 patients had cancer at stage I, 47 at stage II, 41 at stage III, and 16 at stage IV. The AG group included 122 patients, and the control group had 120 healthy donors. The relationship between serum PG levels and the occurrence and development of GC, as well as the evaluation of the clinical value of diagnostic tests based on serum PG detection, were investigated by receiver operating characteristic (ROC) curve analyses.

RESULTS

Pepsinogen I (PGI) levels gradually decreased from the control group, the AG group, and the GC group. PGI exhibited high diagnostic value for GC (area under the curve [AUC], 0.834; cutoff, 51.2 ng/mL, sensitivity, 81.7%; specificity, 68.4%), PGII (AUC, 0.587; cutoff value, 13.05 ng/mL; sensitivity, 65.8%; specificity, 53.8%), and PGR (AUC, 0.752; cutoff, 5.65; sensitivity, 54.2%; specificity, 87.2%). The occurrence of GC was negatively correlated with serum levels of PGI (B = -0.054; OR = 0.947; 95% confidence interval [CI], 0.925-0.970; P <.001) and PGR (B = -0.420; OR = 0.657; 95% CI, 0.499-0.864; P = .003).

CONCLUSIONS

The combined detection of PGI, PGII, and PGR has important clinical value for the screening, prevention, and diagnosis of GC and could allow for earlier detection, diagnosis, and treatment of GC.

Effect of preservation time of formalin-fixed paraffin-embedded tissues on extractable DNA and RNA quantity

OBJECTIVES

This study aimed to investigate the factors affecting the quantity of DNA and RNA extractable from human formalin-fixed paraffin-embedded (FFPE) tissues stored for different lengths of time.

METHODS

We randomly selected 20 FFPE specimens harvested from hysteromyoma patients with uterine fibroids during 2010, 2015, and 2017 at the Department of Pathology, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences. DNA and RNA extractions were performed using a DNA/RNA FFPE kit. DNA and RNA concentrations and their OD₂₆₀/OD₂₈₀ ratios were determined by a NanoDrop 2000 spectrophotometer. The human β-globin gene and aldehyde dehydrogenase-2 (ALDH₂) gene were amplified from nucleic acids using a LightCycler 480 Real-Time PCR System, and PCR amplification products were electrophoresed on 1% agarose gels.

RESULTS

Specimens that were stored for longer showed more degradation and a reduced concentration of DNA and RNA after nucleic acid extraction. However, there was no significant difference in DNA or RNA purity. β-globin and ALDH₂ genes could be amplified from more than 99% of specimens.

CONCLUSION

We found that FFPE tissues stored for longer had a reduced quantity of extractable DNA and RNA. However, these tissues could be used for the analysis of some small target genes.

Hepatitis B X protein upregulates decoy receptor 3 expression via the PI3K/NF-κB pathway

Chronic hepatitis B (CHB) is associated with the development of hepatocellular carcinoma (HCC). Decoy receptor 3 (DcR3) is a tumor necrosis factor receptor that promotes tumor cell survival by inhibiting apoptosis and interfering with immune surveillance. Previous studies showed that DcR3 was overexpressed in HCC cells and that short hairpin RNA (shDcR3) sensitizes TRAIL-resistant HCC cells. However, the expression of DcR3 during hepatitis B virus (HBV) infection has not been investigated. Here, we demonstrated that DcR3 was overexpressed in CHB patients and that DcR3 upregulation was positively correlated with the HBV DNA load and liver injury (determined by histological activity index, serum alanine aminotransferase level, and aspartate aminotransferase level). We found that hepatitis B virus X protein (HBx) upregulated DcR3 expression in a dose-dependent manner, but this increase was blocked by NF-κB inhibitors. HBx also induced the activation of NF-κB, and the NF-κB subunits p65 and p50 upregulated DcR3 by directly binding to the DcR3 promoters. Inhibition of PI3K significantly downregulated DcR3 and inhibited the binding of NF-κB to the DcR3 promoters. Our results demonstrate that the HBx induced DcR3 expression via the PI3K/NF-κB pathway; this process may contribute to the development of HBV-mediated HCC.

ShDcR3 sensitizes TRAIL-resistant HCC cells by inducing caspase-dependent apoptosis while suppressing NF-κB dependent cFLIPL expression

Evidence has shown that most hepatocellular carcinoma (HCC) cells are resistant to tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)-mediated apoptosis. However, the molecular mechanisms underlying TRAIL-mediated apoptosis resistance are not well understood. In this study, we reported that downregulation of Decoy receptor 3 (DcR3) expression by lentiviral vectors carrying shRNA against DcR3 (LV-ShDcR3, shDcR3) in Huh7 both greatly enhanced TRAIL-mediated apoptosis and reduced cell proliferation capability. In addition, silencing DcR3 resulted in upregulation of the cell apoptotic regulators including Bid, caspase-3, and caspase-8. Caspase inhibitors inhibited shDcR3-mediated cell death, which indicated that downregulation of DcR3 expression in Huh7 cells increased TRAIL-induced caspase-dependent apoptotic cell death. Furthermore, although the knockdown of DcR3 altered the expression of some Bcl-2- and IAP-family proteins, this change was inhibited by pretreatment with a pancaspase inhibitor, which indicated the cytotoxic effect of shDcR3 was not due to the expression of these proteins. In contrast, shDcR3 significantly inhibited TRAIL-induced transcription factor nuclear κB (NF-κB) activation through the IκB kinase (IKK) pathway, as well as inhibited TRAIL-induced increases in FLICE-inhibitory protein long form (cFLIP_L) expression at the transcriptional level. Silencing cFLIP_L expression mimicked the cytotoxic effect of shDcR3 on TRAIL-mediated cell apoptosis. Moreover, overexpression of cFLIP_L effectively prevented the increase in cell apoptosis in Huh7 cells co-treated with TRAIL and shDcR3. Taken together, our findings indicated that silencing DcR3 sensitizes TRAIL-mediated apoptosis in HCC cells by inhibiting NF-κB.

Effect of silencing decoy receptor 3 on biological features of hepatoma cells

AIM

To detect the expression of decoy receptor 3 (DcR3) in hepatoma cells, and to investigate its role in the biological features of hepatoma cells.

METHODS

Real-time PCR and Western blot were used to detect the expression of DcR3 mRNA and protein in human hepatoma cell lines HepG2 and Huh7 and normal hepatocytes (HL-7702 and Chang liver). ELISA was used to detect the level of DcR3 protein in the supernatant of these four cell lines. A lentiviral vector carrying shRNA against DcR3 (LV-shDcR3) was synthesized and used to infect HepG2 and Huh7 cells, with the empty lentiviral vector as a control. After infection, the interference effects were determined by Western blot, cell proliferation was assessed by CCK-8 assay and colony forming assay, cell apoptosis was examined by flow cytometry, and the expression of apoptosis related protein like PARP was detected by Western blot. The expression of TRAIL, FasL and LIGHT before and after infection was also detected by Western blot.

RESULTS

The expression of DcR3 was significantly increased in hepatoma cell lines HepG2 and Huh7 both at the mRNA and protein levels compared with normal hepatocytes. The levels of DcR3 in the supernatants of HepG2 and Huh7 cells were also increased. Compared with the mock group and empty lentiviral vector infected group, the LV-shDcR3 infected group showed reduced expression of DcR3, lower cell viability rate, and higher cell apoptosis rate. The expression of TRAIL and FasL was increased after infection with LV-shDcR3 in HepG2 and Huh7 cells.

CONCLUSION

The expression of DcR3 is elevated in hepatoma cells. Down-regulation of the expression of DcR3 inhibits cell proliferation and induces cell apoptosis in hepatoma cells, via mechanisms that may be related with the TRAIL and FasL apoptosis pathway.

[Status and related factors of self-reported pain among working-age population in Inner Mongolia Autonomous Region]

Objective: To describe the status and related factors of self-reported pain among working-age population in Inner Mongolia Autonomous Region (Inner Mongolia). Methods: A cross-sectional study was conducted. Data was from the Inner Mongolia fifth health services survey. SPSS 19.0 software package was used for data analysis and χ² test was to compare the prevalence of self-reported pain in population with different characteristics. Unconditional logistic regression model was used to analyze the related factors on self-reported pain. Results: A total of 11 480 working-age population was involved in this survey, with prevalence of self-reported pain among working age population as 12.3%. The prevalence rates of moderate and severe pain were 11.6% and 0.7%, respectively. Results from the unconditional logistic regression analysis showed that, in the economically poor population, the risk of self-reported pain was 1.718 times of the relatively rich people (OR=1.718, 95%CI: 1.381-2.831). In the rural areas, the risk of self-reported pain was higher than that in the urban population (OR=2.506, 95%CI: 2.030-3.092) and people with chronic illnesses had 2.880 times higher risk than those who did not have the diseases (OR=2.880, 95% CI: 2.474-3.352). There was an interaction noticed between gender and age. Women at or above 45 years old were more likely to develop self-report pain (OR=1.300, 95% CI: 1.072-1.577). Again, factors as people who were current or former smokers, who were suffering from anxiety or depression, being skinny etc. appeared as independently related to the self-reported pain. Conclusion: In working age population of Inner Mongolia, a high prevalence of self-reported pain was seen. Data showed that people who were poor, age at 45 or older, having history of smoking, with chronic diseases and anxiety/depression were risk factors related to self-reported pain.

Ghrelin protects small intestinal epithelium against sepsis-induced injury by enhancing the autophagy of intestinal epithelial cells

BACKGROUND

Ghrelin is a hormone that protects against hypoxic injury of cardiac cells by inducing autophagy, but the role of autophagy in sepsis remains unclear. This study aimed to evaluate whether ghrelin could enhance autophagy in rats with intestinal sepsis.

METHODS

The cecal ligation and perforation (CLP) method was used to induce sepsis in Sprague-Dawley rats. The rats were assigned to four groups: normal group, sham-operated group, sepsis group, and Ghrelin-treated group. Sera and small intestinal tissues were collected from all groups. The sepsis was evaluated by histological analysis, and autophagy of small intestinal epithelial cells was assessed by electron microscopy, immunofluorescence, and biochemical methods.

RESULTS

The expression of autophagy-associated proteins such as LC3, Atg 7 and Beclin 1 increased by 8h post-CLP and declined to basal levels by 12h post-CLP. The expression of LC3, Atg 7 and Beclin 1 in Ghrelin-treated rats was higher than that in rats with sepsis. Furthermore, compared to rats with sepsis, Ghrelin-treated rats showed significantly reduced intestinal mucosa injury at 20h post-CLP.

CONCLUSION

Autophagy is induced in the early stages of sepsis. Ghrelin could enhance the autophagy of intestinal epithelial cells in rats with sepsis and protect the small intestinal epithelium against sepsis-induced injury.

Altered expression of miR-92a correlates with Th17 cell frequency in patients with primary biliary cirrhosis

MicroRNAs (miRNAs or miRs) are small, non-coding RNA molecules that play significant roles in numerous diseases. However, there is limited information regarding the plasma expression of miRNAs in patients with primary biliary cirrhosis (PBC) as well as the potential role of miRNAs in the development of PBC. miRNA microarray analysis was performed using plasma obtaind from three patients with PBC and three healthy controls. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to confirm the differential expression of miRNAs in the plasma and peripheral blood mononuclear cells (PBMCs) isolated from 20 patients with PBC, 20 patients with chronic hepatitis B (CHB) and 20 healthy controls. These miRNAs in PBMCs and plasma were validated by linear regression analyses. The T cell subset frequency was analyzed by flow cytometry. Correlations between altered miRNA expression and the frequency of the T cell subsets were determined by linear regression analyses. The co-expression of miRNAs and IL-17A was examined using fluorescence in situ hybridization (FISH) and immunohistochemistry. The microarray analysis identified sixteen miRNAs that were differentially expressed. Four miRNAs were validated by RT-qPCR. The expression pattern of miR-572 and miR-92a in the PBMCs correlated with the expression pattern in plasma. We also found that miR-92a expression closely correlated with the frequency of a subset of IL-17-producing T helper cells (Th17), and that miR-92a was co-expressed with IL-17A in patients with PBC. Taken together, these findings revealed that plasma from patients with PBC has a unique miRNA expression profile. Moreover, miR-92a may play an important role in the pathogenesis of PBC by regulating Th17 cell differentiation.

Branched DNA-based Alu quantitative assay for cell-free plasma DNA levels in patients with sepsis or systemic inflammatory response syndrome

Cell-free circulating DNA (cf-DNA) can be detected by various of laboratory techniques. We described a branched DNA-based Alu assay for measuring cf-DNA in septic patients. Compared to healthy controls and systemic inflammatory response syndrome (SIRS) patients, serum cf-DNA levels were significantly higher in septic patients (1426.54 ± 863.79 vs 692.02 ± 703.06 and 69.66 ± 24.66 ng/mL). The areas under the receiver operating characteristic curve of cf-DNA for normal vs sepsis and SIRS vs sepsis were 0.955 (0.884-1.025), and 0.856 (0.749-0.929), respectively. There was a positive correlation between cf-DNA and interleukin 6 or procalcitonin or Acute Physiology and Chronic Health Evaluation II. The cf-DNA concentration was higher in intensive care unit nonsurviving patients compared to surviving patients (2183.33 ± 615.26 vs 972.46 ± 648.36 ng/mL; P < .05). Branched DNA-based Alu assays are feasible and useful to quantify serum cf-DNA levels. Increased cf-DNA levels in septic patients might complement C-reactive protein and procalcitonin in a multiple marker format. Cell-free circulating DNA might be a new marker in discrimination of sepsis and SIRS.

Decoy Receptor 3 Improves Survival in Experimental Sepsis by Suppressing the Inflammatory Response and Lymphocyte Apoptosis

Purpose

Unbalanced inflammatory response and lymphocyte apoptosis is associated with high mortality in septic patients. Decoy receptor 3 (DcR3), a member of the tumor necrosis factor receptor superfamily, is an anti-inflammatory and anti-apoptotic factor. Recently, DcR3 expression was found to be increased in septic patients. This study evaluated the therapeutic effect and mechanisms of DcR3 on cecal ligation and puncture (CLP)-induced sepsis in mice.

Methods

C57BL/6 mice were subjected to CLP-induced polymicrobial sepsis. DcR3 Fc was intravenously injected 30 min before and 6 h after CLP. Bacterial clearance, cytokine production, histology, lymphocyte apoptosis and survival were evaluated. Furthermore, we investigated the systemic effects of DcR3 in in vitro lymphocyte apoptosis regulation.

Results

Our results demonstrated that DcR3 protein treatments significantly improved survival in septic mice (p <0.05). Treatment with DcR3 protein significantly reduced the inflammatory response and decreased lymphocyte apoptosis in the thymus and spleen. Histopathological findings of the lung and liver showed milder impairment after DcR3 administration. In vitro experiments showed that DcR3 Fc inhibited Fas-FasL mediated lymphocyte apoptosis.

Conclusions

Treatment with the DcR3 protein protects mice from sepsis by suppressing the inflammatory response and lymphocyte apoptosis. DcR3 protein may be useful in treatment of sepsis.

Effects of urotensin-II on cytokines in early acute liver failure in mice

AIM: To investigate urotensin-II (UII) and its effects on tumor necrosis factor (TNF)-α and interleukin (IL)-1β in early acute liver failure (ALF).

METHODS: We investigated the time-dependent alteration in UII levels and its effects on TNF-α and IL-1β in liver and blood in the early stage of lipopolysaccharide/D-galactosamine-induced ALF.

RESULTS: After lipopolysaccharide/D-galactosamine challenge, UII rose very rapidly and reached a maximal level 0.5 h, and the level remained significantly elevated after 2 h (P < 0.05). Six hours after challenge, UII began to degrade, but remained higher than at 0 h (P < 0.05). Pretreatment with urantide, an inhibitor of the UII receptor, suppressed the degree of UII increase in liver and blood at 6 h after challenge (P < 0.05 vs paired controls). In addition, liver and blood TNF-α increased from 1 to 6 h, and reached a peak at 1 and 2 h, respectively; however, IL-1β did not rise until 6 h after challenge. Urantide pretreatment inhibited the degree of TNF-α and IL-1β increase following downregulation of UII post-challenge (all P < 0.05).

CONCLUSION: UII plays a role in the pathogenesis and priming of ALF by triggering an inflammatory cascade and driving the early release of cytokines in mice.

Urantide inhibits hepatic IRF3 expression in acute liver failure mice

AIM: To investigate the effect of urantide, a urotensin Ⅱ (UⅡ) receptor inhibitor, on interferon regulatory factor 3 (IRF3) expression in the liver tissue of mice with acute liver failure (ALF).

METHODS: Male Balb/c mice were randomly divided into four groups (n = 6 for each group): normal control, pre-treatment control, model and pre-treatment model. The pre-treatment mice received urantide (0.6 mg/kg body weight) via a caudal vein injection. At 30 min post-injection, the model (including pre-treatment model) mice were treated with lipopolysaccharide (LPS)/D-galactosamine (D-GalN) to induce ALF via an intraperitoneal injection. Liver tissues were sampled 12 h after LPS/D-GalN injection. IRF3 mRNA expression was detected by RT-PCR and real-time polymerase chain reaction (PCR), and protein expression was detected by Western blot assay.

RESULTS: The relative levels of IRF3 mRNA were significantly higher in model mice than in control and pretreatment control mice (P < 0.001 for all). Compared with the model group, pretreatment model mice had significant lower levels of IRF3 mRNA (P < 0.001). IRF3 protein levels were also significantly higher in model mice than in control and pretreatment control mice (P < 0.001 for all), while the protein levels were significantly lower in pretreatment model mice than in model mice (P < 0.05).

CONCLUSION: Urantide can inhibit the up-regulation of IRF3 mRNA and protein expression in the liver tissue of mice with LPS/D-GalN-induced ALF.

Progress in understanding role of urotensin Ⅱ in hepatic cirrhosis

Urotensin Ⅱ (UⅡ) is a potent vasoactive substance that can result in vasoactive response through interaction with its specific orphan G-protein-coupled receptor GPR-14. In addition to the role of vasoactivity, UⅡ can promote mitosis and fibrosis. The vascular role of UⅡ is to some degree both species- and disease-specific. Studies have found that plasma levels of UⅡ are elevated in patients with cirrhosis, but the relationship between plasma levels of UⅡ and the development of chronic liver disease and portal hypertension has yet to be fully elucidated. This review focuses on the potential relevance of UⅡ as vasoactive substance in chronic liver disease and the site where UⅡ is overproduced.

Effects of hepatitis B virus X protein on human T cell cytokines

Chronic infection with hepatitis B virus (HBV) plays a significant role in hepatocellular carcinoma development. To investigate the effect of hepatitis B virus X protein (HBx) on inflammatory cytokines of human T cell, a eukaryotic expression vector, HBx-pEGFP-C1, was constructed and transfected into the Jurkat human T-cell line. Jurkat cells were transfected transiently using Lipofectamine 2000 and activated by phytohemagglutinin (PHA). Interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), IL-4, IL-10, IL-13, and IL-14 mRNA was measured. The results showed that the vector HBx-pEGFP-C1 was successfully constructed, and HBx was expressed in Jurkat cells. Compared with a control group, mRNA of IL-1β and TNF-α was significantly elevated in the HBx-pEGFP-C1 group (p < 0.05), while IL-4, IL-10, IL-13, and IL-14 mRNA was decreased (p < 0.05). Therefore, transient overexpression of HBx promoted PHA-induced pro-inflammatory cytokine secretion and repressed anti-inflammatory cytokine secretion in human T cells.

Rat Kupffer cells: Isolation, identification and LPS-stimulated TNF-α expression and secretion

AIM: To isolate, culture and identify rat Kupffer cells, and to investigate the effect of LPS on TNF-α expression and secretion in rat Kupffer cells.

METHODS: Rat liver Kupffer cells (KCs) were isolated and purified by means of in situ perfusion, density gradient centrifugation and early medium change. Isolated cells were identified by ink phagocytosis and ED2 staining test. The expression and secretion of TNF-α was detected by RT-PCR and enzyme-linked immunosorbent assay (ELISA).

RESULTS: Rat liver KCs were successfully isolated, purified, and confirmed by ink phagocytosis and ED2 staining test. Compared with non-stimulated KCs, LPS-stimulated cells had a significantly higher level of TNF-α mRNA expression (1.10 ± 0.02 vs 0.09 ± 0.01, P < 0.001). TNF-α protein levels in cell supernatants were also significantly increased in LPS-stimulated cells than in non-stimulated cells (487.10 pg/mL± 5.56 pg/mL vs 39.41 pg/mL ± 15.30 pg/mL, P < 0.001).

CONCLUSION: Rat KCs have been successfully isolated and purified by means of in situ perfusion and density gradient centrifugation, and LPS can stimulate the expression and secretion of TNF-α.

Expression and role of Urotensin Ⅱ in lipopolysaccharide/D-galactosamine-induced acute liver failure in mice

AIM: To investigate the expression and role of Urotensin Ⅱ (UⅡ) in lipopolysaccharide (LPS)/D-galactosamine (D-GalN)-induced acute liver failure (ALF) in mice.

METHODS: Male Balb/c mice were randomly and equally divided into four groups: normal control group (group A), pre-treatment control group (group B), ALF model group (group C), and pre-treatment model group (group D). ALF were induced in mice by intraperitoneal injection of LPS (50 μg/kg body weight)/D-GalN (800 mg/kg body weight). The pre-treatment mice were intravenously injected with Urantide (0.6 mg/kg body weight) 30 min before model induction. Serum and liver tissues were sampled 12 h after LPS/D-GalN injection. Mortality was calculated 24 h after attack. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected using the Reitman-Frankel method. Histopathological changes were observed by hematoxylin and eosin (HE) staining. Serum UⅡ levels were assessed by ELISA, and the expression of UⅡ and UT was detected by RT-PCR and immunohistochemistry.

RESULTS: A mortality of 66.7% was observed in group C, while all mice of groups A, B and D survived. Serum ALT and AST levels had a dramatic increase in groups C and D, but were significantly lower in group D than in group C (2 271.09 U/L ± 102.24 U/L vs 1 160.67 U/L ± 258.32 U/L, 1 569.42 U/L ± 204.04 U/L vs 1 030.31 U/L ± 108.09 U/L, both P < 0.01). Widespread destruction of liver architecture, hemorrhagic necrosis, and neutrophil infiltration were noted in group C, whereas liver architecture was completely preserved, and focal necrosis and fewer neutrophil infiltrates were observed in group D. After LPS/D-GalN challenge, serum UⅡ levels increased sharply in groups C and D, but were lower in group D than in group C (3.73 μg/L ± 0.52 μg/L vs 1.90 μg/L ± 0.27 μg/L, both P < 0.01). Overexpression of liver UⅡ and UT mRNAs and proteins was induced by the injection of LPS/D-GalN in groups C and D. Compared to group C, group D had lower levels of UⅡ and UT in the liver.

CONCLUSION: UⅡ expression and secretion can be induced by LPS/D-GalN challenge in the liver tissue of ALF mice via a positive feedback mechanism associated with promoting the expression of its receptor UT. UⅡ/UT receptor may be a vital mediator of LPS/D-GalN-induced ALF.

Serum decoy receptor 3, a potential new biomarker for sepsis

BACKGROUND

Sepsis, a common deadly systemic infection caused by a variety of pathogens, has some clinical symptoms similar to the systemic inflammatory response syndrome (SIRS), a whole-body non-infectious inflammatory reaction to severe insults, such as burn, trauma, hypotensive shock and so on. Treatment of sepsis depends mainly on anti-microbial, while remedy for SIRS might require steroids that could possibly enhance the spread of microbes. Unfortunately, it is very difficult to distinguish these two completely different serious conditions without blood culture, which takes days to grow and identify causative pathogens. We examined a biomarker, serum decoy receptor 3 (DcR3), was evaluated for its utility in the differential diagnosis between sepsis and SIRS.

METHODS

Serum DcR3 level in 118 healthy controls, 24 sepsis patients and 43 SIRS patients, was quantitatively measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS

The serum DcR3 was significantly increased in sepsis patients compared with SIRS patients and healthy controls (6.11±2.58 ng/ml vs 2.62±1.46 ng/ml, and 0.91±0.56 ng/ml, respectively, p<0.001). The areas under the receiver operating characteristic curve of DcR3 for the normal vs. SIRS, normal vs. sepsis and SIRS vs. sepsis were 0.910 (0.870-0.950), 0.992 (0.984-1.000) and 0.896 (0.820-0.973), respectively. In addition, the DcR3 exhibited a positive correlation coefficient with APACHE II score, a most commonly used index for the severity of sepsis (r=0.556, p=0.005).

CONCLUSION

The serum DcR3 has a potential to serve as a new biomarker for sepsis with its high specificity and sensitivity.