The Expression And Significance Of MiR-21-5p And MiR-155-5p In Serum Of Patients With Paraquat Poisoning

BackgroundParaquat is a class of organic heterocylic and contact herbicide, absorbed by skin,respiratory tract and digestive tract causing acute poisoning. Paraquat poisoning is the common disease in emergency medicine. With the wider application of paraquat, the incidence of paraquat rises every year recently. It is reported that the mortality is as high as 50%-80%.Paraquat can damage the function of organs, and the lung injury in the most prominent and serious change.ALI(acute lung injury) and ARDS(acute respiratory distress syndrome) is the early manifestation of paraquat poisoning, and the late manifestation is the fibriliation of pulmonary alveoli and pulmonary interstitium. Paraquat is highly toxic, poor prognosis and high mortality. It is significance foe predicting prognosis and directing therapy to explore the related factors of diagnosis and prognosis of paraquat poisoning.MicroRNAs, also known as miRNAs, is a class of small RNAs containing about 19-25 nucleotides. MicroRNAs are widely exist in animals, plants, and virus.As postranscriptional regulation genes, MicroRNAs have played an important role in cell proliferation, differentiation, apoptosis process and so on. They can express stably in serum. In recent years, there are many researches about miR-21-5p and miR-155-5p in inflammatory response, lung injury and pulmonary fibrosis andother pathologic physiology. But there is still lack of clinical research case in the expression and significance of miR-21-5P and miR-155-5P in serum of patients with paraquat poisoning. Real-time fluorescence quantitative PCR is used to detect the expressions of miR-21-5p and mi R-155-5p in serum of patients with paraquat poisoning, so that we can discuss the significance of mi R-21-5p and miR-155-5p for the diagnostic and prognostic of paraquat poisoning.ObjectiveTo study the expression of miR-21-5P and miR-155-5P in serum of patients with paraquat poisoning and combine with clinical indicators, so that we can explore the effect of diagnosis, prognosis and diseases severity of patients with paraquat poisoning MethodsThe patients with paraquat poisoning gathered from the First Affiliated Hospital of Zhengzhou University, from November 2014 to August 2015. They were divided into 3 groups according to urinary concentration of paraquat on admission. The mild group contains 32 cases of paraquat poisoning, whose urinary paraquat concentrations are less than 10μg/ml, and the moderate group contains 42 cases of paraquat poisoning, whose urinary paraquat concentrations range 10μg/ml from 30μg/ml,and the severe group contains 28 cases of paraquat poisoning, whose urinary paraquat concentrations are greater than 30μg/ml. At the same time, 30 cases of healthy persons were selected as the control group. We record each patient’s gender, age, drug dosage, duration from poisoning to treatment, the duration from poisoning to gastric lavage, and the prognosis after 28 days. We also record each patient’s clinical data,such as urinary paraquat concentration, white blood cell count, urea nitrogen, alanine aminotransferase, D dimer, the arterial blood lactic acid, artery blood gas carbon dioxide partial pressure and Acute Physiology and Chronic Health score. In order to evaluate their clinical value in the diagnosis and treatment of paraquat poisoning,Real-time PCR are used to measure the expression of miR-21-5P and miR-155-5P in serum of the 3 groups.Results1.To study the contrast analysis of general data of patients with paraquat poisoning,we find that the 3 group’s gender, age, the duration from poisoning to treatment, the duration from poisoning to gastric lavage of patients are not statistically significant(P>0.05).But the drug dosage white blood cell count, urea nitrogen, alanine aminotransferase,, the arterial blood lactic acid and Acute Physiology, Chronic Health score are statistically significant(P<0.05).2.To analyze diagnostic efficiency of miR-21-5P and mi R-155-5P in serum of patients with paraquat poisoning, we find the area under the ROC curve for miR-21-5P in the diagnosis of sepsis was 0.883(95%CI, 0.813-0.953). When the expression quantity is 0.56, Youden index is maximum value. The area under the ROC curve of mi R-155-5P was 0.839(95%CI, 0.759-0.919). When the expression quantity is 0.67, Youden index is maximum value.3.The expressions of miR-21-5P and miR-155-5P in serum of 3 groups patients with different paraquat poisoning levels are statistically significant(P<0.05).4.Analysis of correlated factors of patients with paraquat poisoning showed that both death group and surviving group’s gender, age, the duration from poisoning to treatment, the duration from poisoning to gastric lavage of patients are not statistically significant(P>0.05).But the drug dosage urinary paraquat concentration,white blood cell count, urea nitrogen, alanine aminotransferase, the arterial blood lactic acid and Acute Physiology, Chronic Health score., miR-21-5P and miR-155-5P of death group are higher than surviving group, and they are statistically significant(P<0.05). The artery blood gas carbon dioxide partial pressure is lower than surviving group, and the results are statistically significant(P<0.05).Conclusions1.The expressions of miR-21-5P and miR-155-5P in serum of patients withparaquat poisoning are higher than healthy group. We can speculate that miR-21-5P and miR-155-5P may participate in the process of paraquat poisoning.2.The expressions of miR-21-5P and miR-155-5P in serum of patients with different paraquat poisoning levels are statistical differences. The expressions of miR-21-5P and miR-155-5P in death group is higher than surviving group, and the results are statistically significant(P < 0.05). Both miR-21-5P and miR-155-5P contribute to paraquat poisoning development and progression. They can act as indexes to estimate order of severity and prognosis of patients with different paraquat.3.miR-21-5P and miR-155-5P have some prospect of clinical application and may act as potential gene markers. They are potential markers in treatment of paraquat poisoning.