miR-21、Caveolin-1、Gal-9在病毒性脑炎患者的表达及相关性研究

Expression and correlation of miR-21,Caveolin-1and Gal-9in patients with viral meningitis

目的探讨病毒性脑炎(viral meningitis,VM)患者脑脊液微小核糖核酸21(micro ribonucleic acid-21,miR-21)表达、陷窝蛋白1(Caveolin-1)、半乳糖凝集素9(galectin-9,Gal-9)水平特点,分析miR-21、Caveolin-1、Gal-9与VM复发的关系。方法选择VM患者(VM组)132例和经检查证实无神经系统损伤的患者(对照组)136例。根据病情将VM患者分为重症组(58例)和轻症组(74例),所有患者出院后随访3个月,根据是否VM复发分为复发组(26例)和无复发组(106例)。治疗前后检测血清miR-21表达、Caveolin-1、Gal-9以及炎性因子水平,分析miR-21、Caveolin-1、Gal-9与VM病情、炎性因子以及复发的关系,受试者工作特征曲线(receiver-operating characteristic curve,ROC)分析miR-21、Caveolin-1、Gal-9预测VM复发的价值。结果VM组miR-21表达、Caveolin-1、Gal-9、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)水平高于对照组(P<0.05)。重症组VM患者脑脊液miR-21表达、Caveolin-1、Gal-9、TNF-α、IL-6水平高于轻症组(P<0.05)。miR-21、Caveolin-1、Gal-9水平均与TNF-α、IL-6呈正相关(P<0.05)。治疗前和治疗前后,复发组脑脊液miR-21表达、Caveolin-1、Gal-9、TNF-α、IL-6水平均高于无复发组,复发组和无复发组患者治疗后脑脊液miR-21表达、Caveolin-1、Gal-9、TNF-α、IL-6水平低于治疗前(P<0.05)。治疗后高TNF-α、miR-21、Caveolin-1、Gal-9是VM复发的危险因素(P<0.05)。联合检测治疗后miR-21、Caveolin-1、Gal-9预测VM复发的AUC为0.858,大于单项指标预测(P<0.05)。结论VM患者脑脊液中miR-21表达、Caveolin-1、Gal-9水平明显增加,治疗后高表达miR-21、高水平Caveolin-1、Gal-9与VM病情严重程度以及复发密切相关。

Objective To investigate the characteristics of the expression level of micro ribonucleic acid-21(miR-21),Caveolin-1 and galectin-9(Gal-9)in cerebrospinal fluid of patients with viral encephalitis(VM),and to analyze the relationship between miR-21,Caveolin-1,Gal-9 and VM recurrence.Methods A total of 132 patients with VM(VM group)and 136 patients without neurological injury confirmed by examination(control group)were selected.VM patients were divided into severe group(n=58)and mild group(n=74)according to their condition.All patients were followed up for 3 months after discharge and divided into recurrence group(n=26)and non-recurrence group(n=106)according to recurrence of VM.The levels of serum miR-21,Caveolin-1,Gal-9 and inflammatory factors were detected before and after treatment,and the relationship between miR-21,Caveolin-1,Gal-9 and VM severity,inflammatory factors and recurrence was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the value of miR-21,Caveolin-1 and Gal-9 in predicting VM recurrence.Results The expression of miR-21 and the levels of Caveolin-1,Gal-9,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in VM group were higher than those in control group(P<0.05).The expression of miR-21 and the levels of Caveolin-1,Gal-9,TNF-αand IL-6 in cerebrospinal fluid of VM patients in severe group were higher than those in mild group(P<0.05).The levels of miR-21,Caveolin-1 and Gal-9 were positively correlated with TNF-αand IL-6(P<0.05).Before and after treatment,the expression of miR-21 and the levels of Caveolin-1,Gsl-9,TNF-αand IL-6 in cerebrospinal fluid of the recurrence group were higher than those of the non-recurrence group.After treatment,the expression of miR-21 and the levels of Caveolin-1,Gal-9,TNF-αand IL-6 in cerebrospinal fluid of patients in recurrence group and non-recurrence group were lower than those before treatment(P<0.05).After treatment,high levels of TNF-α,miR-21,Caveolin-1 and Gal-9 were risk factors for VM recurrence(P<0.05).The area under the ROC curve(AUC)of combined detection of miR-21,Caveolin-1 and Gal-9 in predicting VM recurrence was 0.858,which was higher than that of single index(P<0.05).Conclusion The expression levels of miR-21,Caveolin-1 and Gal-9 in the cerebrospinal fluid of VM patients are significantly increased,and the high expression of miR-21,Caveolin-1 and Gal-9 is closely related to the severity and recurrence of VM after treatment.