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

16. juni 2021 oppdatert av: 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.

Studieoversikt

Status

Påmelding etter invitasjon

Intervensjon / Behandling

Detaljert 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.

Studietype

Observasjonsmessig

Registrering (Forventet)

425

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 70 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Control group
25 gender and age matching healthy controls
ingen inngrep
ARDS group 1
100 ARDS patients at the time of check in hospital
ingen inngrep
ARDS group 2
100 ARDS patients at the time of 24h after check in hospital
ingen inngrep
ARDS group 3
100 ARDS patients at the time of 48h after check in hospital
ingen inngrep
ARDS group 4
100 ARDS patients at the time of 72h after check in hospital
ingen inngrep

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Forventet)

1. juli 2021

Primær fullføring (Forventet)

31. desember 2022

Studiet fullført (Forventet)

31. desember 2023

Datoer for studieregistrering

Først innsendt

11. januar 2020

Først innsendt som oppfylte QC-kriteriene

16. juni 2021

Først lagt ut (Faktiske)

24. juni 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

24. juni 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. juni 2021

Sist bekreftet

1. juni 2021

Mer informasjon

Begreper knyttet til denne studien

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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