在ARDS期间,H因子保留了替代补充功能,这与改善的生存率有关
William Bain1,2, Mohammadreza Tabary1, Sara R Moore3
1Acute Lung Injury Center of Excellence, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
ERJ open research
|June 28, 2023
概括
在急性呼吸窘迫综合征 (ARDS) 患者中,保存的H因子水平与补体激活减少和较低的死亡率相关. 相反,H因子缺乏表明补充因子耗尽和ARDS死亡风险增加.
科学领域:
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 补充激活在急性呼吸困难综合征 (ARDS) 中至关重要.
- H因子是补充替代途径的关键调节者.
- 假设:保存的H因子水平降低了补体激活和ARDS死亡率.
研究的目的:
- 研究H因子水平与ARDS中补充激活之间的关联.
- 确定H因子水平对ARDS患者死亡率的影响.
主要方法:
- 在ARDS患者中评估了替代途径功能 (AH50) (n=218).
- 通过ELISA量化了B因子和H因子水平 (n=224).
- 进行的元分析包括注册表数据 (ALIR) 和试验数据 (LARMA,SAILS).
主要成果:
- 较高的AH50与降低的死亡率相关 (HR 0.66).
- 缺乏H因子与增加的死亡率有关 (HR 1.52).
- 缺乏H因子与补充因子消耗和炎症标志物升高相关.
结论:
- 一部分ARDS患者由于缺乏H因子而表现出补充因子耗尽.
- 这种疲劳会损害补充替代途径的功能,增加死亡率.
- 补充剂的治疗向可能有利于这种ARDS子集.
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