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Joint Modeling of Repeated Measurements of Different Biomarkers Predicts Mortality in COVID-19 Patients in the Intensive Care Unit. 不同生物标志物重复测量的联合建模预测重症监护病房COVID-19患者的死亡率
IF 3.8 Q2 Medicine Pub Date : 2022-07-14 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221112370
Kirby Tong-Minh, Yuri van der Does, Joost van Rosmalen, Christian Ramakers, Diederik Gommers, Eric van Gorp, Dimitris Rizopoulos, Henrik Endeman

Introduction: Predicting disease severity is important for treatment decisions in patients with COVID-19 in the intensive care unit (ICU). Different biomarkers have been investigated in COVID-19 as predictor of mortality, including C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and soluble urokinase-type plasminogen activator receptor (suPAR). Using repeated measurements in a prediction model may result in a more accurate risk prediction than the use of single point measurements. The goal of this study is to investigate the predictive value of trends in repeated measurements of CRP, PCT, IL-6, and suPAR on mortality in patients admitted to the ICU with COVID-19.

Methods: This was a retrospective single center cohort study. Patients were included if they tested positive for SARS-CoV-2 by PCR test and if IL-6, PCT, suPAR was measured during any of the ICU admission days. There were no exclusion criteria for this study. We used joint models to predict ICU-mortality. This analysis was done using the framework of joint models for longitudinal and survival data. The reported hazard ratios express the relative change in the risk of death resulting from a doubling or 20% increase of the biomarker's value in a day compared to no change in the same period.

Results: A total of 107 patients were included, of which 26 died during ICU admission. Adjusted for sex and age, a doubling in the next day in either levels of PCT, IL-6, and suPAR were significantly predictive of in-hospital mortality with HRs of 1.523 (1.012-6.540), 75.25 (1.116-6247), and 24.45 (1.696-1057) respectively. With a 20% increase in biomarker value in a subsequent day, the HR of PCT, IL-6, and suPAR were 1.117 (1.03-1.639), 3.116 (1.029-9.963), and 2.319 (1.149-6.243) respectively.

Conclusion: Joint models for the analysis of repeated measurements of PCT, suPAR, and IL-6 are a useful method for predicting mortality in COVID-19 patients in the ICU. Patients with an increasing trend of biomarker levels in consecutive days are at increased risk for mortality.

导言:预测疾病严重程度对重症监护病房(ICU) COVID-19患者的治疗决策很重要。在COVID-19中,研究了不同的生物标志物作为死亡率的预测因子,包括c反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6 (IL-6)和可溶性尿激酶型纤溶酶原激活物受体(suPAR)。在预测模型中使用重复测量可能比使用单点测量产生更准确的风险预测。本研究的目的是探讨重复测量CRP、PCT、IL-6和suPAR对入住ICU的COVID-19患者死亡率的预测价值。方法:回顾性单中心队列研究。如果患者通过PCR检测SARS-CoV-2呈阳性,并且在ICU入院的任何一天内测量了IL-6、PCT、suPAR,则纳入患者。本研究没有排除标准。我们使用联合模型预测重症监护病房死亡率。该分析是使用纵向和生存数据的联合模型框架完成的。报告的风险比表示,与同一时期没有变化相比,生物标志物价值在一天内增加一倍或20%所导致的死亡风险的相对变化。结果:共纳入107例患者,其中26例在ICU住院期间死亡。经性别和年龄调整后,第二天PCT、IL-6和suPAR水平翻倍均可显著预测住院死亡率,hr分别为1.523(1.012-6.540)、75.25(1.116-6247)和24.45(1.696-1057)。随着随访1天生物标志物值升高20%,PCT、IL-6和suPAR的HR分别为1.117(1.03-1.639)、3.116(1.029-9.963)和2.319(1.149-6.243)。结论:联合模型分析PCT、suPAR和IL-6的重复测量是预测ICU COVID-19患者死亡率的有效方法。连续数日生物标志物水平呈上升趋势的患者死亡风险增加。
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引用次数: 4
The Role of Biomarkers in Hospitalized COVID-19 Patients With Systemic Manifestations. 生物标志物在住院COVID-19全身表现患者中的作用
IF 3.8 Q2 Medicine Pub Date : 2022-06-26 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221108909
Michael Schneider

The following article aims to review COVID-19 biomarkers used in hospital practice. It is apparent that COVID-19 is not simply a pulmonary disease but has systemic manifestations. For this reason, biomarkers must be used in the management of diagnosed patients to provide holistic care. Patients with COVID-19 have been shown to have pulmonary, hepatobiliary, cardiovascular, neurologic, and renal injury, along with coagulopathy and a distinct cytokine storm. Biomarkers can effectively inform clinicians of systemic organ injury due to COVID-19. Furthermore, biomarkers can be used in predictive models for severe COVID-19 in admitted patients. The utility of doing so is to allow for risk stratification and utilization of proper treatment protocols. In addition, COVID-19 biomarkers in the pediatric population are discussed, specifically in predicting Multisystem Inflammatory Syndrome. Ultimately, biomarkers can be used as predictive tools to allow clinicians to identify and adequately manage patients at increased risk for worse outcomes from COVID-19. Both literature review and anecdotal evidence has shown that severe COVID-19 is a systemic disease, and understanding associated biomarkers are crucial for hospitalized patients' proper clinical decision-making. For example, the cytokine storm releases inflammatory markers in different organ systems such as the pulmonary, hepatobiliary, hematological, cardiac, neurological, and renal systems. This review summarizes the latest research of COVID-19 that can help inform healthcare professionals how to better mitigate morbidity and mortality associated with this disease and provides information about certain systemic biomarkers that can be incorporated into hospital practice to provide more comprehensive care for hospitalized COIVD-19 patients.

以下文章旨在回顾在医院实践中使用的COVID-19生物标志物。显然,COVID-19不仅是一种肺部疾病,而且具有全身性表现。因此,生物标志物必须用于诊断患者的管理,以提供整体护理。COVID-19患者已被证明有肺、肝胆、心血管、神经和肾损伤,以及凝血功能障碍和明显的细胞因子风暴。生物标志物可以有效地告知临床医生COVID-19引起的全身器官损伤。此外,生物标志物可用于住院患者重症COVID-19的预测模型。这样做的效用是允许风险分层和使用适当的治疗方案。此外,还讨论了儿童人群中的COVID-19生物标志物,特别是在预测多系统炎症综合征方面。最终,生物标志物可以用作预测工具,使临床医生能够识别和充分管理因COVID-19导致更糟糕结果的风险增加的患者。文献综述和轶事证据都表明,重症COVID-19是一种全身性疾病,了解相关生物标志物对住院患者的正确临床决策至关重要。例如,细胞因子风暴在不同的器官系统中释放炎症标志物,如肺、肝胆、血液、心脏、神经和肾脏系统。本综述总结了COVID-19的最新研究,这些研究可以帮助医疗保健专业人员了解如何更好地降低与该疾病相关的发病率和死亡率,并提供了有关某些系统性生物标志物的信息,这些生物标志物可以纳入医院实践,为住院的COVID-19患者提供更全面的护理。
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引用次数: 6
Glycerophosphoinositol is Elevated in Blood Samples From CLN3 Δex7-8 pigs, Cln3 Δex7-8 Mice, and CLN3-Affected Individuals. CLN3 Δex7-8猪、CLN3 Δex7-8小鼠和CLN3感染个体血液样本中甘油磷酸肌醇升高
IF 3.8 Q2 Medicine Pub Date : 2022-06-19 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221107765
Jon J Brudvig, Vicki J Swier, Tyler B Johnson, Jacob C Cain, Melissa Pratt, Mitch Rechtzigel, Hannah Leppert, An N Dang Do, Forbes D Porter, Jill M Weimer

Introduction: CLN3 Batten disease is a rare pediatric neurodegenerative lysosomal disorder caused by biallelic disease-associated variants in CLN3. Despite decades of intense research, specific biofluid biomarkers of disease status have not been reported, hindering clinical development of therapies. Thus, we sought to determine whether individuals with CLN3 Batten disease have elevated levels of specific metabolites in blood.

Methods: We performed an exhaustive metabolomic screen using serum samples from a novel minipig model of CLN3 Batten disease and validated findings in CLN3 pig serum and CSF and Cln3 mouse serum. We further validate biomarker candidates with a retrospective analysis of plasma and CSF samples collected from participants in a natural history study. Plasma samples were evaluated from 22 phenotyped individuals with CLN3 disease, 15 heterozygous carriers, and 6 non-affected non-carriers (NANC).

Results: CLN3 pig serum samples from 4 ages exhibited large elevations in 4 glycerophosphodiester species: glycerophosphoinositol (GPI), glycerophosphoethanolamine (GPE), glycerophosphocholine (GPC), and glycerophosphoserine (GPS). GPI and GPE exhibited the largest elevations, with similar elevations found in CLN3 pig CSF and Cln3 mouse serum. In plasma samples from individuals with CLN3 disease, glycerophosphoethanolamine and glycerophosphoinositol were significantly elevated with glycerophosphoinositol exhibiting the clearest separation (mean 0.1338 vs 0.04401 nmol/mL for non-affected non-carriers). Glycerophosphoinositol demonstrated excellent sensitivity and specificity as a biomarker, with a receiver operating characteristic area under the curve of 0.9848 (P = .0003).

Conclusions: GPE and GPI could have utility as biomarkers of CLN3 disease status. GPI, in particular, shows consistent elevations across a diverse cohort of individuals with CLN3. This raises the potential to use these biomarkers as a blood-based diagnostic test or as an efficacy measure for disease-modifying therapies.

介绍:CLN3巴顿病是一种罕见的小儿神经退行性溶酶体疾病,由CLN3双等位基因疾病相关变异引起。尽管经过数十年的深入研究,疾病状态的特异性生物流体生物标志物尚未报道,这阻碍了临床治疗的发展。因此,我们试图确定患有CLN3巴顿病的个体是否具有血液中特定代谢物水平升高。方法:我们使用一种新型CLN3巴滕病迷你猪模型的血清样本进行了详尽的代谢组学筛选,并验证了CLN3猪血清和CSF以及CLN3小鼠血清中的发现。我们通过对自然历史研究参与者的血浆和脑脊液样本进行回顾性分析,进一步验证候选生物标志物。对22名表型型CLN3疾病患者、15名杂合携带者和6名未受影响的非携带者(NANC)的血浆样本进行了评估。结果:4个年龄段的CLN3猪血清样本中,甘油磷酸肌醇(GPI)、甘油磷酸乙醇胺(GPE)、甘油磷酸胆碱(GPC)和甘油磷酸丝氨酸(GPS) 4种甘油磷酸二酯含量均显著升高。GPI和GPE的升高幅度最大,CLN3猪CSF和CLN3小鼠血清中GPI和GPE的升高幅度相似。在CLN3疾病患者的血浆样本中,甘油磷酸乙醇胺和甘油磷酸肌醇显著升高,其中甘油磷酸肌醇分离最明显(未受影响的非携带者平均为0.1338 vs 0.04401 nmol/mL)。甘油磷酸肌醇作为生物标志物具有良好的敏感性和特异性,曲线下的受试者工作特征面积为0.9848 (P = 0.0003)。结论:GPE和GPI可作为CLN3疾病状态的生物标志物。特别是,GPI在不同的CLN3患者队列中显示一致的升高。这提高了使用这些生物标志物作为基于血液的诊断测试或作为疾病改善治疗的疗效测量的潜力。
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引用次数: 3
Elevated Levels of Pleiotropic Interleukin-6 (IL-6) and Interleukin-10 (IL-10) are Critically Involved With the Severity and Mortality of COVID-19: An Updated Longitudinal Meta-Analysis and Systematic Review on 147 Studies. 多效白细胞介素-6(IL-6)和白细胞介素-10(IL-10)水平升高与 COVID-19 的严重程度和死亡率密切相关:对147项研究的最新纵向荟萃分析和系统综述。
IF 3.4 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-06-16 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221106600
Sarah Jafrin, Md Abdul Aziz, Mohammad Safiqul Islam

Objectives: Disruption in the natural immune reaction due to SARS-CoV-2 infection can initiate a potent cytokine storm among COVID-19 patients. An elevated level of IL-6 and IL-10 during a hyperinflammatory state plays a vital role in increasing the risk of severity and mortality. In this study, we aimed to evaluate the potential of circulating IL-6 and IL-10 levels as biomarkers for detecting the severity and mortality of COVID-19.

Methods: This study was conducted according to the Cochrane Handbook and PRISMA guidelines. Authorized databases were searched to extract suitable studies using specific search terms. RevMan 5.4 was applied for performing the meta-analysis. Mean differences in IL-6 and IL-10 levels were calculated among COVID-19 patients via a random-effects model. NOS scoring, publication bias and sensitivity analyses were checked to ensure study quality.

Results: A total of 147 studies were selected, with 31 909 COVID-19 patients under investigation. In the severity analysis, the mean concentration of IL-6 was significantly higher in the severe COVID-19 cases than in the non-severe cases (MD: 19.98; P < .001; 95% CI: 17.56, 22.40). Similar result was observed for IL-10 mean concentration in severe COVID-19 cases (MD: 1.35; P < .001; 95% CI: 0.90, 1.80). In terms of mortality analysis, circulating IL-6 showed sharp elevation in the deceased patients (MD: 42.11; P < .001; 95% CI: 36.86, 47.36). IL-10 mean concentration was higher in the dead patients than in the survived patients (MD: 4.79; P < .001; 95% CI: 2.83, 6.75). Publication bias was not found except for comparing IL-6 levels with disease severity. Sensitivity analysis also reported no significant deviation from the pooled outcomes.

Conclusions: Elevated levels of circulating IL-6 and IL-10 signifies worsening of COVID-19. To monitor the progression of SARS-CoV-2 infection, IL-6 and IL-10 should be considered as potential biomarkers for severity and mortality detection in COVID-19.

Systematic review registration: INPLASY registration number: INPLASY202240046.

目的SARS-CoV-2 感染导致的自然免疫反应紊乱会在 COVID-19 患者中引发强烈的细胞因子风暴。在高炎症状态下,IL-6 和 IL-10 水平的升高在增加严重程度和死亡率风险方面起着至关重要的作用。本研究旨在评估循环 IL-6 和 IL-10 水平作为检测 COVID-19 严重程度和死亡率的生物标志物的潜力:本研究根据 Cochrane 手册和 PRISMA 指南进行。使用特定检索词对授权数据库进行检索,以提取合适的研究。应用RevMan 5.4进行荟萃分析。通过随机效应模型计算了COVID-19患者IL-6和IL-10水平的平均差异。为确保研究质量,对NOS评分、发表偏倚和敏感性分析进行了检查:结果:共选取了 147 项研究,对 31 909 名 COVID-19 患者进行了调查。在严重程度分析中,COVID-19重症患者的IL-6平均浓度明显高于非重症患者(MD:19.98;P P P P结论:循环中IL-6水平升高可能与COVID-19的严重程度有关:循环中 IL-6 和 IL-10 水平升高意味着 COVID-19 的病情恶化。为监测 SARS-CoV-2 感染的进展,IL-6 和 IL-10 应被视为检测 COVID-19 严重程度和死亡率的潜在生物标志物:INPLASY注册号:INPLASY202240046。
{"title":"Elevated Levels of Pleiotropic Interleukin-6 (IL-6) and Interleukin-10 (IL-10) are Critically Involved With the Severity and Mortality of COVID-19: An Updated Longitudinal Meta-Analysis and Systematic Review on 147 Studies.","authors":"Sarah Jafrin, Md Abdul Aziz, Mohammad Safiqul Islam","doi":"10.1177/11772719221106600","DOIUrl":"10.1177/11772719221106600","url":null,"abstract":"<p><strong>Objectives: </strong>Disruption in the natural immune reaction due to SARS-CoV-2 infection can initiate a potent cytokine storm among COVID-19 patients. An elevated level of IL-6 and IL-10 during a hyperinflammatory state plays a vital role in increasing the risk of severity and mortality. In this study, we aimed to evaluate the potential of circulating IL-6 and IL-10 levels as biomarkers for detecting the severity and mortality of COVID-19.</p><p><strong>Methods: </strong>This study was conducted according to the Cochrane Handbook and PRISMA guidelines. Authorized databases were searched to extract suitable studies using specific search terms. RevMan 5.4 was applied for performing the meta-analysis. Mean differences in IL-6 and IL-10 levels were calculated among COVID-19 patients via a random-effects model. NOS scoring, publication bias and sensitivity analyses were checked to ensure study quality.</p><p><strong>Results: </strong>A total of 147 studies were selected, with 31 909 COVID-19 patients under investigation. In the severity analysis, the mean concentration of IL-6 was significantly higher in the severe COVID-19 cases than in the non-severe cases (MD: 19.98; <i>P</i> < .001; 95% CI: 17.56, 22.40). Similar result was observed for IL-10 mean concentration in severe COVID-19 cases (MD: 1.35; <i>P</i> < .001; 95% CI: 0.90, 1.80). In terms of mortality analysis, circulating IL-6 showed sharp elevation in the deceased patients (MD: 42.11; <i>P</i> < .001; 95% CI: 36.86, 47.36). IL-10 mean concentration was higher in the dead patients than in the survived patients (MD: 4.79; <i>P</i> < .001; 95% CI: 2.83, 6.75). Publication bias was not found except for comparing IL-6 levels with disease severity. Sensitivity analysis also reported no significant deviation from the pooled outcomes.</p><p><strong>Conclusions: </strong>Elevated levels of circulating IL-6 and IL-10 signifies worsening of COVID-19. To monitor the progression of SARS-CoV-2 infection, IL-6 and IL-10 should be considered as potential biomarkers for severity and mortality detection in COVID-19.</p><p><strong>Systematic review registration: </strong>INPLASY registration number: INPLASY202240046.</p>","PeriodicalId":47060,"journal":{"name":"Biomarker Insights","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/32/10.1177_11772719221106600.PMC9209786.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40392026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progress Toward a Multiomic Understanding of Traumatic Brain Injury: A Review. 外伤性脑损伤多组学研究进展综述
IF 3.8 Q2 Medicine Pub Date : 2022-06-13 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221105145
Philip A Kocheril, Shepard C Moore, Kiersten D Lenz, Harshini Mukundan, Laura M Lilley

Traumatic brain injury (TBI) is not a single disease state but describes an array of conditions associated with insult or injury to the brain. While some individuals with TBI recover within a few days or months, others present with persistent symptoms that can cause disability, neuropsychological trauma, and even death. Understanding, diagnosing, and treating TBI is extremely complex for many reasons, including the variable biomechanics of head impact, differences in severity and location of injury, and individual patient characteristics. Because of these confounding factors, the development of reliable diagnostics and targeted treatments for brain injury remains elusive. We argue that the development of effective diagnostic and therapeutic strategies for TBI requires a deep understanding of human neurophysiology at the molecular level and that the framework of multiomics may provide some effective solutions for the diagnosis and treatment of this challenging condition. To this end, we present here a comprehensive review of TBI biomarker candidates from across the multiomic disciplines and compare them with known signatures associated with other neuropsychological conditions, including Alzheimer's disease and Parkinson's disease. We believe that this integrated view will facilitate a deeper understanding of the pathophysiology of TBI and its potential links to other neurological diseases.

创伤性脑损伤(TBI)不是一种单一的疾病状态,而是描述了一系列与大脑侮辱或损伤相关的情况。有些创伤性脑损伤患者会在几天或几个月内康复,而另一些患者则会出现持续的症状,可能导致残疾、神经心理创伤,甚至死亡。由于多种原因,理解、诊断和治疗TBI是极其复杂的,包括头部撞击的不同生物力学,损伤的严重程度和位置的差异,以及个体患者的特征。由于这些混杂因素,对脑损伤的可靠诊断和靶向治疗的发展仍然难以捉摸。我们认为,开发有效的TBI诊断和治疗策略需要在分子水平上对人类神经生理学有深入的了解,而多组学的框架可能为这种具有挑战性的疾病的诊断和治疗提供一些有效的解决方案。为此,我们在此全面回顾了来自多学科的TBI生物标志物候选物,并将其与其他神经心理疾病(包括阿尔茨海默病和帕金森病)相关的已知特征进行了比较。我们相信,这一综合观点将有助于更深入地了解创伤性脑损伤的病理生理学及其与其他神经系统疾病的潜在联系。
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引用次数: 2
Volatile Organic Compounds Analysis as a Potential Novel Screening Tool for Breast Cancer: A Systematic Review. 挥发性有机化合物分析作为一种潜在的新型乳腺癌筛查工具:系统综述
IF 3.8 Q2 Medicine Pub Date : 2022-05-23 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221100709
Michelle Leemans, Pierre Bauër, Vincent Cuzuel, Etienne Audureau, Isabelle Fromantin

Introduction: An early diagnosis is crucial in reducing mortality among people who have breast cancer (BC). There is a shortfall of characteristic early clinical symptoms in BC patients, highlighting the importance of investigating new methods for its early detection. A promising novel approach is the analysis of volatile organic compounds (VOCs) produced and emitted through the metabolism of cancer cells.

Methods: The purpose of this systematic review is to outline the published research regarding BC-associated VOCs. For this, headspace analysis of VOCs was explored in patient-derived body fluids, animal model-derived fluids, and BC cell lines to identify BC-specific VOCs. A systematic search in PubMed and Web of Science databases was conducted according to the PRISMA guidelines.

Results: Thirty-two studies met the criteria for inclusion in this review. Results highlight that VOC analysis can be promising as a potential novel screening tool. However, results of in vivo, in vitro and case-control studies have delivered inconsistent results leading to a lack of inter-matrix consensus between different VOC sampling methods.

Discussion: Discrepant VOC results among BC studies have been obtained, highly due to methodological discrepancies. Therefore, methodological issues leading to disparities have been reviewed and recommendations have been made on the standardisation of VOC collection and analysis methods for BC screening, thereby improving future VOC clinical validation studies.

早期诊断对于降低乳腺癌(BC)患者的死亡率至关重要。BC患者缺乏特征性的早期临床症状,这突出了研究早期发现BC的新方法的重要性。一种很有前途的新方法是分析通过癌细胞代谢产生和排放的挥发性有机化合物(VOCs)。方法:本系统综述的目的是概述有关bc相关VOCs的已发表研究。为此,研究人员在患者体液、动物模型体液和BC细胞系中对VOCs进行了顶空分析,以识别BC特异性VOCs。根据PRISMA指南对PubMed和Web of Science数据库进行系统检索。结果:32项研究符合纳入本综述的标准。结果表明,挥发性有机化合物分析是一种有潜力的新型筛选工具。然而,体内、体外和病例对照研究的结果不一致,导致不同VOC取样方法之间缺乏基质间的共识。讨论:在BC研究中获得了不同的VOC结果,这很大程度上是由于方法上的差异。因此,本文回顾了导致差异的方法学问题,并对用于BC筛查的VOC收集和分析方法的标准化提出了建议,从而改进了未来VOC的临床验证研究。
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引用次数: 13
Query About Validity of uVDBP as a Biomarker of Steroid-Resistant Nephrotic Syndrome. 关于uVDBP作为类固醇抵抗性肾病综合征生物标志物的有效性的质疑。
IF 3.8 Q2 Medicine Pub Date : 2022-02-07 eCollection Date: 2022-01-01 DOI: 10.1177/11772719221078372
Ahmed H Aoun
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引用次数: 1
Evaluation of a Prognostic Epigenetic Classification System in Chronic Lymphocytic Leukemia Patients. 慢性淋巴细胞白血病患者预后表观遗传分类系统的评价。
IF 3.8 Q2 Medicine Pub Date : 2022-01-19 eCollection Date: 2022-01-01 DOI: 10.1177/11772719211067972
Christina Grimm, Carmen Diana Herling, Anastasia Komnidi, Michelle Hussong, Karl-Anton Kreuzer, Michael Hallek, Michal R Schweiger

Background: Methylation at 5 CpG sites was previously shown to classify chronic lymphocytic leukemia (CLL) into 3 prognostic subgroups. Here, we aimed to validate the marker set in an additional cohort and to evaluate its clinical utility for CLL patient stratification.

Methods: We evaluated this epigenetic marker set in 79 German patients using bisulfite treatment followed by pyrosequencing and classification using a support vector machine-learning tool.

Results: The n-CLL, i-CLL, and m-CLL classification was detected in 28 (35%), 10 (13%), and 41 (51%) patients, respectively. Epigenetic grouping was associated with IGHV mutational status (P = 2 × 10-12), isolated del13q (P = 9 × 10-6), del17p (P = .015), complex karyotype (P = .005), VH-usage, and clinical outcome as time to first treatment (P = 1.4 × 10-12) and overall survival (P = .003). Multivariate Cox regression analysis identified n-CLL as a factor for earlier treatment hazard ratio (HR), 6.3 (95% confidence interval [CI] 2.4-16.4; P = .0002) compared to IGHV mutational status (HR 4.6, 95% CI 1.9-11.3, P = .0008). In addition, when comparing the prognostic value of the epigenetic classification system with the IGHV classification, epigenetic grouping performed better compared to IGHV mutational status using Kaplan-Meier estimation and allowed the identification of a third, intermediate (i-CLL) group. Thus, our study confirmed the prognostic value of the epigenetic marker set for patient stratification in routine clinical diagnostics.

背景:5个CpG位点的甲基化先前被证明可以将慢性淋巴细胞白血病(CLL)分为3个预后亚组。在这里,我们的目的是在另一个队列中验证该标记集,并评估其在CLL患者分层中的临床应用。方法:我们在79名德国患者中使用亚硫酸氢盐治疗,然后使用焦磷酸测序和使用支持向量机器学习工具进行分类,评估了这一表观遗传标记集。结果:n-CLL、i-CLL和m-CLL分型分别为28例(35%)、10例(13%)和41例(51%)。表观遗传分组与IGHV突变状态(P = 2 × 10-12)、分离del13q (P = 9 × 10-6)、del17p (P = 0.015)、复杂核型(P = 0.005)、vh使用、临床转归(P = 1.4 × 10-12)和总生存期(P = 0.003)相关。多因素Cox回归分析发现,n-CLL是早期治疗风险比(HR)的一个因素,为6.3(95%可信区间[CI] 2.4-16.4;P = 0.0002)与IGHV突变状态相比(HR 4.6, 95% CI 1.9-11.3, P = 0.0008)。此外,当比较表观遗传分类系统与IGHV分类的预后价值时,使用Kaplan-Meier估计,表观遗传分组比IGHV突变状态表现更好,并允许识别第三个中间(i-CLL)组。因此,我们的研究证实了表观遗传标记在常规临床诊断中对患者分层的预后价值。
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引用次数: 2
Identification of Potential Urinary Metabolite Biomarkers of Pseudomonas aeruginosa Ventilator-Associated Pneumonia 铜绿假单胞菌呼吸机相关性肺炎潜在尿液代谢物生物标志物的鉴定
IF 3.8 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1177/11772719221099131
B. Jongers, A. Hotterbeekx, Kenny Bielen, P. Vervliet, J. Boddaert, C. Lammens, E. Fransen, G. Baggerman, A. Covaci, H. Goossens, S. Malhotra-Kumar, P. Jorens, S. Kumar-Singh
Introduction: Ventilator-associated pneumonia (VAP) caused by Pseudomonas aeruginosa is a major cause of morbidity and mortality in hospital intensive care units (ICU). Rapid identification of P. aeruginosa-derived markers in easily accessible patients’ samples can enable an early detection of P. aeruginosa VAP (VAP-PA), thereby stewarding antibiotic use and improving clinical outcomes. Methods: Metabolites were analysed using liquid chromatography-mass spectrometry (LC-MS) in prospectively collected urine samples from mechanically ventilated patients admitted to the Antwerp University Hospital ICU. Patients were followed from the start of mechanical ventilation (n = 100 patients) till the time of clinical diagnosis of VAP (n = 13). Patients (n = 8) in whom diagnosis of VAP was further confirmed by culturing respiratory samples and urine samples were studied for semi-quantitative metabolomics. Results: We first show that multivariate analyses highly discriminated VAP-PA from VAP–non-PA as well as from the pre-infection groups (R2 = .97 and .98, respectively). A further univariate analysis identified 58 metabolites that were significantly elevated or uniquely present in VAP-PA compared to the VAP–non-PA and pre-infection groups (P < .05). These comprised both a known metabolite of histidine as well as a novel nicotine metabolite. Most interestingly, we identified 3 metabolites that were not only highly upregulated for, but were also highly specific to, VAP-PA, as these metabolites were completely absent in all pre-infection timepoints and in VAP–non-PA group. Conclusions: Considerable differences exist between urine metabolites in VAP-PA compared to VAP due to other bacterial aetiologies as well to non-VAP (pre-infection) timepoints. The unique urinary metabolic biomarkers we describe here, if further validated, could serve as highly specific diagnostic biomarkers of VAP-PA.
由铜绿假单胞菌引起的呼吸机相关性肺炎(VAP)是医院重症监护病房(ICU)发病和死亡的主要原因。在易于获取的患者样本中快速鉴定铜绿假单胞菌衍生的标记物可以早期发现铜绿假单胞菌VAP (VAP- pa),从而管理抗生素的使用并改善临床结果。方法:采用液相色谱-质谱联用(LC-MS)对安特卫普大学医院ICU收治的机械通气患者前瞻性尿液样本进行代谢物分析。随访患者从机械通气开始(n = 100例)至临床诊断为VAP时(n = 13例)。通过培养呼吸样本和尿液样本进一步证实VAP诊断的患者(n = 8)进行半定量代谢组学研究。结果:我们首先发现多变量分析高度区分了VAP-PA与vap -非pa以及感染前组(R2 =。分别为97和0.98)。进一步的单变量分析发现,与vap -非pa组和感染前组相比,VAP-PA组中58种代谢物显著升高或仅存在(P < 0.05)。这包括一种已知的组氨酸代谢物和一种新的尼古丁代谢物。最有趣的是,我们发现了3种代谢物,它们不仅对VAP-PA高度上调,而且对VAP-PA高度特异性,因为这些代谢物在所有感染前时间点和vap -非pa组中完全不存在。结论:与VAP相比,由于其他细菌病因以及非VAP(感染前)时间点,VAP- pa尿液代谢物存在相当大的差异。我们在这里描述的独特的尿液代谢生物标志物,如果进一步验证,可以作为高度特异性的VAP-PA诊断生物标志物。
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引用次数: 0
Advantages and Limitations of Monitoring Circulating Tumor DNA Levels to Predict the Prognosis of Patients Diagnosed With Gastric Cancer. 监测循环肿瘤DNA水平预测胃癌患者预后的优势与局限性。
IF 3.8 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.1177/11772719221141525
Wan He, Jingxin Yang, Xiao Sun, Shunda Jiang, Jinchan Jiang, Ming Liu, Tianhao Mu, Yingmei Li, Xiaoni Zhang, Jingxian Duan, Ruilian Xu

Next-generation sequencing-based genomic profiling facilitates biomarker detection by cell-free DNA (cfDNA) liquid biopsy. However, the efficiency of mutation calling and the prognostic value of cfDNA biomarkers are disputed. We investigated 24 patients with gastric cancer in this study, using a 605-gene sequencing panel to sequence their plasma cfDNA and tumor tissue DNA. The mutation concordance between plasma cfDNA and tumor tissue DNA was 70.6% in stage IV gastric cancer and 30.2% in stage III gastric cancer, indicating insufficient mutation detection rates in stage III and early-stage cancer. When compared with total cfDNA load and blood tumor mutation burden (bTMB), the variant allele frequencies (VAF) of commonly mutated genes are highly accurate in representing disease burden. Further, VAF are a better prognostic indicator compared with serum biomarkers including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), cancer antigen 125 (CA125), and alpha-fetoprotein (AFP). The use of cfDNA in molecular profiling of patients allows prediction of patient survival and clinical response, as well as the development of personalized therapy regimens.

下一代基于测序的基因组图谱有助于通过无细胞DNA (cfDNA)液体活检检测生物标志物。然而,突变召唤的效率和cfDNA生物标志物的预后价值存在争议。在本研究中,我们调查了24例胃癌患者,使用605基因测序板对其血浆cfDNA和肿瘤组织DNA进行测序。血浆cfDNA与肿瘤组织DNA的突变一致性在IV期胃癌中为70.6%,在III期胃癌中为30.2%,表明在III期和早期癌症中突变检出率不足。与总cfDNA负荷和血液肿瘤突变负荷(bTMB)相比,常见突变基因的变异等位基因频率(VAF)在表征疾病负担方面具有较高的准确性。此外,与癌胚抗原(CEA)、碳水化合物抗原19-9 (CA19-9)、癌抗原125 (CA125)和甲胎蛋白(AFP)等血清生物标志物相比,VAF是一个更好的预后指标。在患者分子谱分析中使用cfDNA可以预测患者的生存和临床反应,以及制定个性化的治疗方案。
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引用次数: 1
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Biomarker Insights
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