Expression and clinical significance of miR-16-5p and IFITM3 in peripheral blood mononuclear cells of patient with sepsis-associated acute kidney injury

Objective To detect the expression of microRNA-16-5p(miR-16-5p) and interferon-induced transmembrane protein 3(IFITM3) in peripheral blood mononuclear cells of septic patients with sepsis-associated acute kidney injury(S-AKI) and examine the clinical significance of the two in S-AKI patients.Methods During February 2019 to February 2021, 106 septic patients were selected as research subjects.Septic patients with acute kidney injury(AKI) were included in AKI group(n=52) and those without AKI in non-AKI group(n=54).The 3 ml of blood samples from all patients was harvested for separating monocytes, real-time fluorescent quantitative technology for detecting the expression levels of miR-16-5p and IFITM3 mRNA in peripheral blood mononuclear cells, enzyme-linked immunosorbent assay for determining the level of interleukin-1β(IL-1β) in peripheral blood, automatic biochemical analyzer for detecting the levels of cysteine(Cys) and blood urea nitrogen(BUN) in peripheral blood;clinical parameters and the expression levels of miR-16-5p and IFITM3 mRNA were compared between two groups, Pearson's method was performed to analyze the correlation between miR-16-5p, IFITM3 mRNA and BUN/Cys level and the correlation between miR-16-5p and IFITM3 mRNA expression levels, multiple linear regression was utilized for examining the influencing factors of miR-16-5p and IFITM3 mRNA expression, receiver operator characteristic(ROC) curve was plotted for evaluating the diagnostic value of miR-16-5p and IFITM3 mRNA for S-AKI in septic patients.Results The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score(15.67±4.39 vs 13.31±3.56), sequential organ failure assessment(SOFA) score(5.62±1.28 vs 4.89±1.41), levels of IL-1β(22.03±5.78) mg/L vs (10.44±3.05) mg/L, Cys(2.72±0.45) mg/L vs (1.98±0.31) mg/Land BUN(7.93±2.24) μmol/L vs (4.49±2.07) μmol/Lwere higher in AKI group than those in non-AKI group(P<0.05), the expression level of miR-16-5p(1.64±0.30 vs 1.17±0.28) in AKI group was significantly up-regulated, the expression level of IFITM3 mRNA(2.87±0.62 vs 4.06±0.92) and protein(1.63±0.41 vs 3.15±0.85) were significantly down-regulated(P<0.05);the expression level of miR-16-5p in patient with S-AKI was positively correlated with the levels of IL-1β(r=0.531, P<0.05), Cys(r=0.482, P<0.05) and BUN(r=0.560, P<0.05), the expression level of IFITM3 mRNA was negatively correlated with the levels of IL-1β(r=-0.754, P<0.05), Cys(r=-0.554, P<0.05) and BUN(r=-0.695, P<0.05), the expression levels of miR-16-5p and IFITM3 mRNA were negatively correlated(r=-0.496, P<0.05);multiple linear regression analysis indicated that elevations of IL-1β and Cys were the influencing factors of miR-16-5p and IFITM3 mRNA expression levels(P<0.05);the area under the curve(AUC) s of miR-16-5p and IFITM3 mRNA single test for diagnosing S-AKI in septic patients were 0.876(95%CI:0.809~0.944) and 0.874(95%CI:0.811~0.938), the AUC of miR-16-5p and IFITM3 mRNA combined detection was 0.956(95%CI:0.929~0.992).Conclusion In S-AKI patients, the expression of miR-16-5p is up-regulated while the expression of IFITM3 down-regulated.Both are closely correlated with the pathological process of S-AKI.It may aggravate kidney injury by promoting inflammation, aid in an early diagnosis of S-AKI and provide a promising therapeutic target for S-AKI.