Article ; Online: Lung tissue expression of epithelial injury markers is associated with acute lung injury severity but does not discriminate sepsis from ARDS.
2024 Volume 25, Issue 1, Page(s) 129
Abstract: Background: Acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients, and diffuse alveolar damage (DAD) is considered its histological hallmark. Sepsis is one of the most common aetiology of ARDS ... ...
| Abstract | Background: Acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients, and diffuse alveolar damage (DAD) is considered its histological hallmark. Sepsis is one of the most common aetiology of ARDS with the highest case-fatality rate. Identifying ARDS patients and differentiate them from other causes of acute respiratory failure remains a challenge. To address this, many studies have focused on identifying biomarkers that can help assess lung epithelial injury. However, there is scarce information available regarding the tissue expression of these markers. Evaluating the expression of elafin, RAGE, and SP-D in lung tissue offers a potential bridge between serological markers and the underlying histopathological changes. Therefore, we hypothesize that the expression of epithelial injury markers varies between sepsis and ARDS as well as according to its severity. Methods: We compared the post-mortem lung tissue expression of the epithelial injury markers RAGE, SP-D, and elafin of patients that died of sepsis, ARDS, and controls that died from non-pulmonary causes. Lung tissue was collected during routine autopsy and protein expression was assessed by immunohistochemistry. We also assessed the lung injury by a semi-quantitative analysis. Results: We observed that all features of DAD were milder in septic group compared to ARDS group. Elafin tissue expression was increased and SP-D was decreased in the sepsis and ARDS groups. Severe ARDS expressed higher levels of elafin and RAGE, and they were negatively correlated with PaO Conclusions: Lung tissue expression of elafin and RAGE, but not SP-D, is associated with ARDS severity, but does not discriminate sepsis patients from ARDS patients. |
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| MeSH term(s) | Humans ; Elafin ; Pulmonary Surfactant-Associated Protein D ; Lung ; Respiratory Distress Syndrome/diagnosis ; Acute Lung Injury ; Sepsis/diagnosis ; Sepsis/complications |
| Chemical Substances | Elafin ; Pulmonary Surfactant-Associated Protein D |
| Language | English |
| Publishing date | 2024-03-18 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2041675-1 |
| ISSN | 1465-993X ; 1465-993X |
| ISSN (online) | 1465-993X |
| ISSN | 1465-993X |
| DOI | 10.1186/s12931-024-02761-x |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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