title: Identification of four novel serum protein biomarkers in sepsis patients encoded by target genes of sepsis-related miRNAs.
abstract: The goal of the present study was to identify novel protein biomarkers from the target genes of six serum miRNAs that we identified previously in patients with sepsis. The target genes were predicted by bioinformatics analysis; the levels of the respective proteins in the sera of patients with sepsis were detected by ELISA. ACVR2A (activin A receptor, type IIA), FOXO1 (forkhead box O1), IHH (Indian hedgehog), STK4 (serine/threonine kinase 4) and DUSP3 (dual specificity phosphatase 3) were predicted to be the targets of the six miRNAs, and their encoded proteins were used for biomarker identification. Levels of ACVR2A (P<0.01) and FOXO1 (P<0.01) were significantly different among normal controls, patients with sepsis, patients with severe sepsis and patients with septic shock. Furthermore, levels of ACVR2A (P=0.025), FOXO1 (P<0.001), IHH (P=0.001) and STK4 (P=0.001) were differentially expressed in survivors and non-survivors. DUSP3 levels were not significantly different between any groups. Conjoin analysis of the four differentially expressed proteins showed that the area under the curve of the predictive probabilities was 0.875 [95% CI (confidence interval): 0.785-0.965], which was higher than the SOFA (Sequential Organ Failure Assessment) and APACHE II (Acute Physiology and Chronic Health Evaluation II) scores. When the value of predictive probabilities was 0.449, the four proteins yielded a sensitivity of 68% and a specificity of 91%. Dynamic changes in ACVR2A, FOXO1 and IHH levels showed differential expression between survivors and non-survivors at all time points. On the basis of a combined analysis of the four identified proteins, their predictive value of 28-day mortality of patients with sepsis was better than the SOFA or APACHE II scores.
authors.forename: Hui-juan
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: ‡Department of Respiratory Medicine, the Affiliated Beijing Tiantan Hospital of Capital Medical University, Beijing, 100050, China.
authors.forename: Bao-zeng
authors.initials: BZ
authors.lastname: Wang
authors.affiliation: §Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Peng-jun
authors.initials: PJ
authors.lastname: Zhang
authors.forename: Jie
authors.initials: J
authors.lastname: Deng
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Zhi-rui
authors.initials: ZR
authors.lastname: Zhao
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xiao
authors.affiliation: ¶Department of Medical Statistics, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Feng
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Yan-hong
authors.initials: YH
authors.lastname: Jia
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: You-ning
authors.initials: YN
authors.lastname: Liu
authors.affiliation: *Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Xie
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D018805:Sepsis / Q000097:blood*
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D035683:MicroRNAs