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. 2021 Feb 25;21(1):66.
doi: 10.1186/s12890-021-01437-2.

Plasma mitochondrial DNA levels are associated with acute lung injury and mortality in septic patients

Jia-Yu Mao #  1 , Dong-Kai Li #  1 , Hong-Min Zhang  1 , Xiao-Ting Wang  2 , Da-Wei Liu  3
Affiliations

Plasma mitochondrial DNA levels are associated with acute lung injury and mortality in septic patients

Jia-Yu Mao et al. BMC Pulm Med. .

Abstract

Background: Mitochondrial DNA (mtDNA) is a critical activator of inflammation. Circulating mtDNA released causes lung injury in experimental models. We hypothesized that elevated plasma mtDNA levels are associated with acute lung injury (ALI) in septic patients.

Methods: We enrolled 66 patients with sepsis admitted to the Department of Critical Care Medicine of Peking Union Medical College Hospital between January 2019 and October 2019. Respiratory, hemodynamic and bedside echocardiographic parameters were recorded. Plasma mtDNA, procalcitonin, interleukin 6, and interleukin 8 levels were examined.

Results: Plasma mtDNA levels within 24 h after admission were significantly increased in the group of septic patients with ALI [5.01 (3.38-6.64) vs 4.13 (3.20-5.07) log copies/µL, p 0.0172]. mtDNA levels were independently associated with mortality (hazard ratio, 3.2052; 95% CI 1.1608-8.8500; p 0.0253) and ALI risk (odds ratio 2.7506; 95% CI 1.1647-6.4959; p 0.0210). Patients with high mtDNA levels had worse outcomes, and post hoc tests showed significant differences in 28-day survival rates. Increased mtDNA levels were seen in patients with abdominal infection.

Conclusions: Increased plasma mtDNA levels within 24 h after admission were significantly associated with ALI incidence and mortality in septic patients.

Keywords: Acute lung injury; Biomarkers; Plasma mtDNA level; Sepsis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Comparison of mtDNA level in different groups. a MtDNA level in septic patients with or without acute lung injury. b MtDNA level in septic ALI patients with different infectious sources. ALI acute lung injury. *p < 0.05
Fig. 2
Fig. 2
The relationships between mtDNA level and the prognostic outcome. a The cutoff value of mtDNA was calculated from the receiver operating characteristic curve, and this value was used to determine the prognostic significance. b The cutoff values of mtDNA level were used to determine the prognostic significance. AUC area under the curve, NLR negative likelihood ratio, PLR positive likelihood ratio, PPV positive predictive value, YI Youden index
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