Association Between Serum miR-221-3p and Intravenous Immunoglobulin Resistance in Children With Kawasaki Disease

ObjectivesIntravenous immunoglobulin (IVIG) resistance was a major cause of coronary artery lesions in children with Kawasaki disease (KD). However, the cause of IVIG resistance in KD remains unknown. miR-221-3p has been confirmed involved in cardiovascular diseases and rheumatoid arthritis. The purpose of this study was to investigate the association between miR-221-3p and IVIG resistance in children with KD.Methods55 KD patients and 29 healthy controls (HCs) were enrolled in this study. KD patients were divided into group of sensitive to IVIG (IVIG-response, n=42) and group of resistant to IVIG (IVIG-resistance, n=13). Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used to detect the levels of miR-221-3p.ResultsCompared with the HCs group, miR-221-3p were significantly increased in the KD group (p < 0.05), and the IVIG-resistance group had higher levels of miR-221-3p than those in the IVIG-response group (p < 0.05). CRP (C-reactive protein), PCT (procalcitonin), NLR (neutrophil-lymphocyte ratio) were positively correlated with miR-221-3p in KD patients. In addition, the group of IVIG resistance had a higher level of Kobayashi Score (p <0.001). The receiver operating characteristic (ROC) curve showed that miR-221-3p had a better value for diagnosis IVIG resistance in children with KD than Kobayashi Score and the combination of both with the AUC of 0.811 (95% CI, 0.672-0.951), 0.793 (95% CI, 0.618-0.968) and 0.797 (95% CI, 0.619-0.974), respectively.ConclusionsmiR-221-3p might be involved in the pathogenesis of KD and IVIG resistance and miR-221-3p can be used as a new potential biomarker to predict of IVIG resistance in children with KD.

NEUTROPHIL-LYMPHOCYTE COUNT RATIO IN BACTERIAL SEPSIS (Rasio Neutrofil-Limfosit Pada Sepsis Bakterial)

Sepsis akibat infeksi bakteri merupakan masalah kegawatdaruratan medik yang serius sehingga memerlukan penanganan cepat dantepat. Saat ini C-RP (C- reactive protein) dan PCT (procalcitonin) sering digunakan sebagai petanda sepsis bakterial. Sepsis adalah infeksiyang disertai inflamasi sistemik. Respons fisiologis terhadap inflamasi sistemik adalah peningkatan jumlah neutrofil dan penurunanjumlah limfosit, sehingga gabungan perbandingan neutrofil dan limfosit Neutrophil Lymphocyte Count Ratio (NLCR)) dapat digunakansebagai petanda sepsis. Penelitian ini bertujuan untuk mengetahui kepekaan dan kekhasana dari uji NLCR di pasien sepsis akibatinfeksi bakteri. Terdapat 70 pasien SIRS dengan rentang usia 14–70 tahun di RS Mitra Keluarga Bekasi Timur dan RS FK - UKI Jakartamasa waktu bulan Juli–September 2015. Penelitian ini merupakan studi observasional komparatif dan potong lintang. Hasil penelitianmenunjukkan uji NLCR terhadap sepsis bakterial berdasarkan kurva ROC memiliki kepekaan 97,8% dan kekhasan 84,0% pada cutoff ≥6,4 (AUC: 0,94, nilai p<0,05). Neutrophil lymphocyte count ratio dapat diandalkan sebagai petanda sepsis bakterial dengan ujikepekaan dan kekhasan yang baik.