Urinary 8-oxo-7,8-dihydroguanosine as a potential biomarker for the prognosis of acute poisoning patients in the emergency Intensive-care unit: a prospective observational study.

IF 3.6 3区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Ya-Min Dang, Chao-Jie Chen, Ya-Qing Ma, Hong-Lei Liu, Wei Wen, Jin-Hua Quan, Ren-Ai Xu, Jun Dong, Zhong-Qiu Lu, Jian-Ping Cai
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Abstract

Acute poisoning remains a significant cause of admission to the emergency intensive-care unit (EICU). Despite a reduced mortality rate, attention is increasingly focusing on the impact of post-intensive-care syndrome (PICS) on readmission. Due to the significant role of oxidative stress (OS) in the pathological mechanisms of poisoning, 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) may hold great potential as biomarkers for OS biomarkers to evaluate the severity and prognosis of poisoning. Therefore, we investigated the longitudinal changes of urinary 8-oxoGuo levels during hospitalization in poisoned patients, their association with organ failure, and their predictive value for 30-day readmission risk. In total, 43 poisoning patients were enrolled from the EICU of the First Affiliated Hospital of Wenzhou Medical University between July 2021 and November 2022. The 30-day readmission rate was 18.6%. Group-based trajectory modeling (GBTM) was used to explore the potential trajectories of urinary OS markers and organ failure scores during hospitalization. Spearman's correlation analysis revealed a significant association between a high trajectory of 8-oxoGuo/creatinine (Cr) and the increased severity of overall organ failure, as well as respiratory and coagulation dysfunctions. Binary logistic regression analysis indicated that a high 8-oxoGuo/Cr trajectory, high respiratory failure score trajectory, and 8-oxoGuo/Cr values at three key points in disease progression (including admission, transfer from EICU, and discharge), along with 8-oxodGuo/Cr levels at admission, were all risk factors for 30-day readmission. The 8-oxoGuo/Cr value at discharge exhibited the best predictive performance. The urinary 8-oxoGuo/Cr ratio may serve as a potential biomarker for prognostic evaluations in patients with poisoning.

尿8-氧-7,8-二氢鸟苷作为急诊重症监护病房急性中毒患者预后的潜在生物标志物:一项前瞻性观察研究
急性中毒仍然是进入紧急重症监护病房(EICU)的一个重要原因。尽管死亡率降低,但人们越来越关注重症监护后综合征(PICS)对再入院的影响。由于氧化应激(OS)在中毒病理机制中的重要作用,8-氧-7,8-二氢鸟苷(8-oxoGuo)和8-氧-7,8-二氢-2'-脱氧鸟苷(8-oxodGuo)可能具有作为OS生物标志物评估中毒严重程度和预后的巨大潜力。因此,我们研究了中毒患者住院期间尿8-氧过水平的纵向变化、它们与器官衰竭的关系以及它们对30天再入院风险的预测价值。2021年7月至2022年11月,温州医科大学第一附属医院EICU共纳入43例中毒患者。30天再入院率为18.6%。采用基于组的轨迹模型(GBTM)探讨住院期间尿OS标志物和器官衰竭评分的潜在轨迹。Spearman的相关分析显示,8-氧过/肌酐(Cr)的高轨迹与整体器官衰竭以及呼吸和凝血功能障碍的严重程度增加之间存在显著关联。二元logistic回归分析显示,8-oxoGuo/Cr轨迹高、呼吸衰竭评分轨迹高、疾病进展三个关键点(入院、从EICU转出和出院)的8-oxoGuo/Cr值以及入院时的8-oxoGuo/Cr水平都是30天再入院的危险因素。放电时8-oxoGuo/Cr值的预测效果最好。尿8-氧过/铬比值可作为中毒患者预后评估的潜在生物标志物。
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来源期刊
Free Radical Research
Free Radical Research 生物-生化与分子生物学
CiteScore
6.70
自引率
0.00%
发文量
47
审稿时长
3 months
期刊介绍: Free Radical Research publishes high-quality research papers, hypotheses and reviews in free radicals and other reactive species in biological, clinical, environmental and other systems; redox signalling; antioxidants, including diet-derived antioxidants and other relevant aspects of human nutrition; and oxidative damage, mechanisms and measurement.
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