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The Mechanism of lncRNA NEAT1 in Alleviating Acute Respiratory Distress Syndrome Through miR-27b Regulated Nrf2 Pathway

16. juni 2021 opdateret af: Guangfa Zhu, Beijing Anzhen Hospital
The acute respiratory distress syndrome, formerly known as the acute lung injury (ARDS/ALI), is a critical illness with high mortality due to the lack of effective treatment. The pathogenesis of ARDS/ALI has not been fully elucidated. Nuclear factor E2-related factor 2 (Nrf2) plays a key role in regulating lung inflammation and oxidative stress which are closely related to lung injury in ARDS/ALI, but its regulatory mechanism remains unclear. The investigator's provious study shown that microRNA-27b (miR-27b) downregulated Nrf2 to aggravate lung inflammation and histological injury. Furthermore, in lipopolysaccharide (LPS)-induced cell (J774A.1) inflammation model, miR-27b was upregulated while the long non-coding RNA (lncRNA) NEAT1 was downregulated, the putative binding sites of lncRNA NEAT1 and miR-27b were successfully predicted by bioinformatics approach. Thus, the investigators propose that NEAT1 plays as a competing endogenous RNA (ceRNA) to adsorb miR-27b and liberate Nrf2, therefore, to attenuate lung inflammation and related lung injury in ARDS/ALI. This project aims to explore the role of the lncRNA NEAT1/ mir-27b /Nrf2 signal axis in the development and treatment of ARDS/ALI in patients, as well as in LPS-induced ALI animal and cell models by using bioinformatics, molecular biology, histomorphology and clinical phenotype approaches, and to clarify the new mechanism in ARDS/ALI development and to provide new therapeutic targets.

Studieoversigt

Status

Tilmelding efter invitation

Intervention / Behandling

Detaljeret beskrivelse

Collect blood and BALF from 400 ARDS patients at different time (at check-in, 24, 48 and 72 h after check-in the hospital) and 25 gender and age matching healthy controls. Use RT-PCR to detect the expression of lncRNA NEAT1、miR-27b and Nrf2 in blood and BALF of ARDS patients and health controls. The expressions of inflammatory and oxidative stress associated factors (NLRP3、NF-κB-P65、 p-P65、IκB、p-IκB、HO-1、NQO1、caspase-1、IL-1β、IL-6、IL-18、TNF-α) will be detected by western blot、ELISA and RT-PCR. Moreover, flow cytometry will be adopted to measure the numbers and kinds of cells in BALF. Then, analyze the differences of the expressions of lncRNA NEAT1、miR-27b and Nrf2 in the groups. To explore the correlation of expressions of lncRNA NEAT1、miR-27b and Nrf2 with inflammation and oxidative stress in the groups. Finally, to declare the relative of lncRNA NEAT1、miR-27b and Nrf2 with the time of mechanical ventilation, severity and mortality in 28 days of ARDS patients.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

425

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Beijing
      • Beijing, Beijing, Kina, 100029
        • Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 70 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

We included ARDS patients from RICU、EICU、SICU、CCU in Beijing Anzhen hospital between 2020 and 2022

Beskrivelse

Inclusion Criteria:

We included patients with acute respiratory distress according to 2012 ARDS Berlin new definition (Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA, 2012, 307(23):2526).

  • Acute or progressive dyspnea within 1 week with identify cause;
  • Chest radiograph/chest CT showed double lung infiltration, which could not be fully explained by pleural effusion, atelectasis, or nodules;
  • Respiratory failure cannot be fully explained by heart failure and fluid overload;
  • Hypoxemia, partial pressure of oxygen in arterial blood (PaO2)/oxygen fraction in air (FIO2) <150 mm Hg under PEEP ≥5 cm H2O, (mild ARDS: 200mmHg<PaO2/FiO2≤300mmHg, moderate ARDS: 100mmHg<PaO2/FiO2≤200mmHg, severe ARDS: PaO2/FiO2≤100mmHg);
  • 18~70 years old;
  • Agree to participate in the trial, and sign the informed consent.

Exclusion Criteria:

  • Age less than 18 years old;
  • Time of hospital stay <24 h;
  • Pregnancy;
  • Using V-V ECOM;
  • Cardiac index <1.5L·ml.min-1.m-2;
  • Pulmonary resection;
  • Pulmonary embolism ;
  • Refused to participate in the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Control group
25 gender and age matching healthy controls
intet indgreb
ARDS group 1
100 ARDS patients at the time of check in hospital
intet indgreb
ARDS group 2
100 ARDS patients at the time of 24h after check in hospital
intet indgreb
ARDS group 3
100 ARDS patients at the time of 48h after check in hospital
intet indgreb
ARDS group 4
100 ARDS patients at the time of 72h after check in hospital
intet indgreb

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The expression of lncRNA NEAT1 in blood and BALF in all groups
Tidsramme: up to 24 day
Use RT-PCR to measure the expression of lncRNA NEAT1 in blood and BALF in all groups
up to 24 day
The expression of miR-27b in blood and BALF in all groups
Tidsramme: up to 3 day
Use RT-PCR to measure the expression of miR-27b in blood and BALF in all groups
up to 3 day
The expression of Nrf2 in blood and BALF in all groups
Tidsramme: up to 3 day
Use RT-PCR and Wsetern blot to measure the expression of Nrf2 in blood and BALF in all groups
up to 3 day
The expression of inflammatory factors(IL-1β、IL-6、IL-18、TNF-α) in blood and BALF in all groups
Tidsramme: up to 3 day
Use RT-PCR and ELISA to measure the expression of inflammatory factors(IL-1β、IL-6、IL-18、TNF-α) in blood and BALF in all groups
up to 3 day
The expression of oxidative stress associated factors in blood and BALF in all groups
Tidsramme: up to 3 day
Use Western blot to measure the expression of oxidative stress associated factors(NLRP3、NF-κB-P65、 p-P65、IκB、p-IκB、HO-1、NQO1、caspase-1) in blood and BALF in all groups
up to 3 day
The numbers and kinds of inflammatory cells in BALF and blood in all groups
Tidsramme: up to 3 day
Use flow cytometry to detect the number of inflammatory cells in BALF and blood in all groups
up to 3 day
The kinds of inflammatory cells in BALF and blood in all groups
Tidsramme: up to 3 day
Use flow cytometry to detect the kinds of inflammatory cells(neutrophile、macrophage、 lymphocyte) in BALF and blood in all groups
up to 3 day
The time of mechanical ventilation of patients in ARDS groups
Tidsramme: up to28 day
Record the time of mechanical ventilation of patients in ARDS groups
up to28 day
The severity of ARDS patients in ARDS groups
Tidsramme: up to 28 day
Record the severity(PaO2/FiO2、OI、S/F、OSI) of ARDS patients in ARDS groups
up to 28 day
the mortality in 28 days of ARDS patients
Tidsramme: up to 28 day
Record the mortality in 28 days of ARDS patients
up to 28 day

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The differences and correlation of the expressions of lncRNA NEAT1、miR-27b and Nrf2 in the groups
Tidsramme: up to 28 day
Analyse the differences of the expressions of lncRNA NEAT1、miR-27b and Nrf2 in the groups, and to explore the relations between the three(lncRNA NEAT1、miR-27b and Nrf2) in different groups.
up to 28 day
The correlation of expressions of lncRNA NEAT1、miR-27b and Nrf2 with inflammation and oxidative stress in the groups.
Tidsramme: up to 28 day
To explore the correlation of expressions of lncRNA NEAT1、miR-27b and Nrf2 with inflammation and oxidative stress in the groups.
up to 28 day
The relative of lncRNA NEAT1、miR-27b and Nrf2 with the time of mechanical ventilation, severity and mortality in 28 days of ARDS patients
Tidsramme: up to 28 day
To declare the relative of lncRNA NEAT1、miR-27b and Nrf2 with the time of mechanical ventilation, severity and mortality in 28 days of ARDS patients
up to 28 day

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Forventet)

1. juli 2021

Primær færdiggørelse (Forventet)

31. december 2022

Studieafslutning (Forventet)

31. december 2023

Datoer for studieregistrering

Først indsendt

11. januar 2020

Først indsendt, der opfyldte QC-kriterier

16. juni 2021

Først opslået (Faktiske)

24. juni 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juni 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. juni 2021

Sidst verificeret

1. juni 2021

Mere information

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