COVID-19患者KIM-1与suPAR水平的关系评价及suPAR的不同视角

B. Kerget, F. Kerget, A. Aksakal, S. Askin, E. Uçar, L. Sağlam
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摘要

目的:COVID-19是上个世纪最重要的健康问题之一,我们对这种疾病的认识仍然有限。在我们的研究中,我们旨在比较COVID-19患者血清可溶性尿激酶纤溶酶原激活物受体(suPAR)和肾损伤分子-1(KIM-1)水平与临床病程的关系。方法:选取2020年9月至2020年12月通过鼻咽交换和实时PCR方法诊断为covid -19的18岁以上患者102例,以及鼻咽交换后PCR阴性的18岁以上志愿医务人员30例。采用酶联免疫吸附法测定KİM-1和suPAR。结果:NLR、LDH、凝血酶原时间、CRP、PaO2/FiO2、d -二聚体、铁蛋白、纤维蛋白原等在既往研究中被认为对covid -19预后有重要意义的指标在重症组中升高(p值分别为0.001、0.001、0.05、0.001、0.001、0.005、0.001、0.001)。与对照组相比,患者组suPAR和kim -1水平具有统计学意义(p=0.001)。重症患者suPAR水平明显低于中度患者(p=0.034),而重症患者KIM-1水平明显高于中度患者(p=0.001)。结论:重症患者的KIM-1水平升高,被认为在SARS-CoV-2向细胞内吞过程中起重要作用,可能在未来的治疗靶点中占有重要地位。SuPAR可被认为在防御机制和纤溶中发挥重要作用,重症患者其水平降低可能与早期预后不良有关。然而,需要广泛的研究才能得出关于suPAR的明确意见。
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Evaluation of the relationship between KIM-1 and suPAR level in COVID-19 patients and a different perspective on suPAR
Objective: COVID-19 is one of the most important health problems concerning the last century and our knowledge of the disease is still limited. In our study, we aimed to compare serum-soluble urokinase plasminogen activator receptor (suPAR) and kidney injury molecule-1 (KIM-1) level with clinical course in COVID-19 patients. Methods: Our study included 102 patients over the age of 18 who were diagnosed with Covid-19 between September 2020 and December 2020 by taking nasopharyngeal swap and using real time PCR method and 30 volunteer medical personnel over the age of 18 who were PCR negative after the nasopharyngeal swap. KİM-1 and suPAR were measured by enzyme-linked immunosorbent assay. Results: NLR, LDH, prothrombin time, CRP, PaO2/FiO2, D-Dimer, ferritin and fibrinogen levels, which have been mentioned in previous studies to be of prognostic importance for COVID-19, were observed to be higher in the severely ill group (p=0,001, 0,001, 0,05, 0,001, 0,001, 0,005, 0,001, 0,001 respectively). suPAR and KIM-1 levels were statistically significantly higher in patient groups compared to the control group (p=0.001 for all). While suPAR level was statistically significantly lower in severe patients compared to moderate patients (p=0.034), KIM-1 level was observed to be higher in severe patients (p=0.001). Conclusion: The increased level of KIM-1 in severe patients, which is thought to play an important role in the endocytosis of SARS-CoV-2 to the cell, may have an important place for the therapeutic target in the future. SuPAR can be considered to play an important role especially in the defense mechanism and fibrinolysis and its decreased level in severe patients may be associated with poor prognosis in the early period. However, extensive studies are needed to reach a definitive opinion about suPAR.
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