Serum RIPK1, Acute Lung Injury, and Outcomes in Severe Traumatic Brain Injury: A Multicenter Prospective Study.

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2025-03-20 eCollection Date: 2025-01-01 DOI:10.2147/TCRM.S502775
Liang Cai, Xianghong Dou, Wensheng Dong, Kangqin Zou, Lixin Zhang, Huayong Hong, Xiaole Zhang, Jin Liu, Da Tian, Xiaoyu Wu, Jianhua Zhang
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引用次数: 0

Abstract

Background: Receptor-interacting protein kinase-1 (RIPK1), a regulator of necroptosis, is involved in acute brain injury and acute lung injury (ALI). Here, serum RIPK1 levels were measured after severe traumatic brain injury (sTBI), with an endeavor to unveil its prognostic implications and mediation effects of ALI.

Methods: In this multicenter prospective study, serum RIPK1 levels were gauged in 100 healthy individuals and 158 sTBI patients in need of decompressive craniectomy for brain herniation. The collected materials encompassed the Glasgow Coma Scale (GCS), pupil enlargement status, basal cisternal shapes, ALI, etc. The extended Glasgow outcome scale (GOSE) was employed for estimating neurological impairments at posttraumatic 180-day mark. Multifactorial analytical methods were applied to assess relevancies.

Results: Patients, as opposed to controls, had markedly raised serum RIPK1 levels, with the even substantially higher levels in those with lower GCS scores, bilateral pupil enlargement or obliterated basal cisterns. Using restricted cubic spline, RIPK1 levels were linearly related to occurrent risks of the four outcome variables of interest, that is 180-day death, overall survival, poor prognosis (GOSE scores 1-4) and ALI. RIPK1 levels independently predicted these outcome variables. RIPK1 levels had noninteractional effects with age, sex, hypertension, diabetes, smoking and alcohol habits in terms of its association with these outcome variables. RIPK1 levels exhibited high discriminatory efficiency for these outcome variables under the receiver operating characteristic curve. RIPK1 levels, via partial mediation by ALI, were associated with death and poor prognosis of patients.

Conclusion: Elevated serum RIPK1 levels of patients with sTBI may be highly related to trauma severity, and risks of poor outcomes and ALI; and ALI partially explains the links between serum RIPK1 levels, death and poor prognosis, substantializing serum RIPK1 as a serological prognostic predictor of good prospect in sTBI.

血清RIPK1、急性肺损伤和严重创伤性脑损伤的预后:一项多中心前瞻性研究
背景:受体相互作用蛋白激酶1 (Receptor-interacting protein kinase-1, RIPK1)是坏死性上睑垂的调节因子,参与急性脑损伤和急性肺损伤(acute pulmonary injury, ALI)。在这里,我们测量了严重创伤性脑损伤(sTBI)后的血清RIPK1水平,试图揭示其预后意义和ALI的中介作用。方法:在这项多中心前瞻性研究中,测定了100名健康个体和158名需要颅脑减压手术治疗脑疝的sTBI患者的血清RIPK1水平。收集的资料包括格拉斯哥昏迷评分(GCS)、瞳孔扩大状况、基底池形状、ALI等。采用扩展格拉斯哥结局量表(GOSE)评估创伤后180天的神经损伤。应用多因素分析方法评估相关性。结果:与对照组相比,患者血清RIPK1水平明显升高,GCS评分较低、双侧瞳孔增大或基底池闭塞的患者血清RIPK1水平甚至更高。使用受限三次样条,RIPK1水平与四个结果变量的发生风险线性相关,即180天死亡、总生存、不良预后(GOSE评分1-4)和ALI。RIPK1水平独立地预测了这些结果变量。RIPK1水平与年龄、性别、高血压、糖尿病、吸烟和饮酒习惯的相关性与这些结果变量无关。在受试者工作特征曲线下,RIPK1水平对这些结果变量表现出较高的区分效率。通过ALI的部分介导,RIPK1水平与患者死亡和不良预后相关。结论:sTBI患者血清RIPK1水平升高可能与创伤严重程度、不良结局和ALI风险高度相关;而ALI部分解释了血清RIPK1水平、死亡和预后不良之间的联系,证实了血清RIPK1是sTBI中前景良好的血清学预后预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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