Analysis of the relationship between serum Melatonin,MIP-1α,NLRP3 inflammasome and prognosis in children with acute respiratory distress syndrome
10.3969/j.issn.1673-4130.2024.11.011
- VernacularTitle:急性呼吸窘迫综合征患儿血清Melatonin、MIP-1α与NLRP3炎症小体和预后的关系分析
- Author:
Juan YU
1
;
Jian WANG
;
Huawei DU
;
Xueqin YANG
;
Jie YANG
Author Information
1. 眉山市人民医院儿科,四川眉山 620010
- Keywords:
acute respiratory distress syndrome;
Melatonin;
macrophage inflammatory protein-1α;
nucleotide-binding oligomerization domain-like receptor protein 3
- From:
International Journal of Laboratory Medicine
2024;45(11):1331-1337
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the relationship between serum Melatonin,macrophage inflammatory pro-tein-1α(MIP-1α)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflamma-some and prognosis in children with acute respiratory distress syndrome(ARDS).Methods A total of 140 children with ARDS who were admitted to the hospital from January 2021 to January 2023 were enrolled as the ARDS group,and 100 healthy children who underwent physical examination during the same period were enrolled as the control group.According to the clinical outcome on 28 d after admission,the children with ARDS were divided into a death group(29 cases)and a survival group(111 cases).Enzyme-linked immu-nosorbent assay was used to detect the serum levels of Melatonin,MIP-1α,interleukin(IL)-1β,and IL-18.Re-al-time fluorescent quantitative PCR was used to detect the mRNA levels of NLRP3 and Caspase-1.Pearson correlation was used to analyze the correlation between serum levels of Melatonin and MIP-1α and NLRP3 in-flammasome related indicators(NLRP3 mRNA,Caspase-1 mRNA,IL-1β,IL-18)in children with ARDS.Mul-tivariate Cox regression analysis was used to analyze the factors affecting the prognosis of children with ARDS.According to the mean levels of serum Melatonin and MIP-1α,the children with ARDS were divided in-to a high/low Melatonin group and MIP-1α group.The Kaplan-Meier method was used to draw the survival curves of ARDS children with high/low levels of serum Melatonin and MIP-1α.The receiver operating charac-teristic(ROC)curve was used to analyze the predictive value of serum Melatonin and MIP-1α for death in children with ARDS.Results Compared with the control group,the ARDS group had a significantly decreased serum Melatonin level and significantly increased serum MIP-1α,IL-1β,IL-18 and NLRP3 mRNA and Caspase-1 mRNA levels in peripheral blood mononuclear cells(P＜0.05).Pearson correlation analysis showed that the serum Melatonin level of ARDS children was negatively correlated with NLRP3 mRNA,Caspase-1 mRNA,IL-1β and IL-18(P＜0.05),the level of MIP-1α was positively correlated with NLRP3 mR-NA,Caspase-1 mRNA,IL-1β and IL-18(P＜0.05).Multivariate Cox regression analysis showed that acute physiology and chronic health evaluation Ⅱ score,NLRP3 mRNA,Caspase-1 mRNA,IL-1β,IL-18 and MIP-1αwere independent risk factors affecting the prognosis of children with ARDS.Melatonin was an independent protective factor(P＜0.05).Kaplan-Meier survival curve analysis showed that the 28 d survival rate in high Melatonin group was higher than that in low Melatonin group(P＜0.05),and the 28 d survival rate in high MIP-1α group was lower than that in low MIP-1α group(P＜0.05).ROC curve analysis showed that the area under the curve of Melatonin and MIP-1α combined to predict the death of ARDS children was 0.881(95％CI 0.816-0.930).It was higher than 0.785(95％CI 0.708-0.850)and 0.778(95％CI 0.700-0.844)predic-ted by Melatonin or MIP-1α alone.Conclusion The serum Melatonin level is decreased and MIP-1α level is in-creased in children with ARDS,which is closely related to NLRP3 inflammasome and prognosis.Combined de-tection of serum Melatonin and MIP-1α levels has a high predictive value for the prognosis of children with ARDS.
