Gene score to quantify systemic inflammation in patients with acutely decompensated cirrhosis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Trebicka Jonel, Aguilar Ferran, Queiroz Farias Alberto, Lozano Juan-José, Sánchez-Garrido Cristina, Usón-Raposo Eva, de la Peña-Ramirez Carlos, Sidorova Julia, Curto-Vilalta Anna, Sierra-Casas Patricia, Momoyo Zitelli Patricia, Papp Maria, Pereira Gustavo, Caraceni Paolo, Goncalves Luciana L, Alessandria Carlo, Torre Aldo, Laleman Wim, Gadano Adrián, Piano Salvatore, Mattos Angelo Z, Gu Wenyi, Brol Maximilian Joseph, Schierwagen Robert, Uschner Frank Erhard, Fischer Julia, Mendes Liliana S C, Vargas Victor, Alvares-da-Silva Mario R, Mookerjee Raj, Bittencourt Paolo L, Benitez Carlos, Albillos Agustín, Couto Cláudia, Mendizabal Manuel, Bañares Rafael, Toledo Claudio L, Mazo Daniel F, Janicko Martin, Castillo-Barradas Mauricio, Padilla Machaca Pedro Martin, Gatti Pietro, Miranda Adelina Zarela-Lozano, Malé-Velázquez René, Zipprich Alexander, Castro-Lyra André, Gustot Thierry, Bernal William, Gerbes Alexander L, Jalan Rajiv, Fernández Javier, Angeli Paolo, Carrilho Flair Jose, Claria Joan, Moreau Richard, Arroyo Vicente, PREDICT study and ACLARA study
Аннотация
METHODS: Standard biomarkers (white cell count, C reactive protein, cytokines) and genome-wide RNA expression (RNA-sequencing) were obtained in blood from 700 patients with ADC at the time of their hospital admission. A composite score based on standard biomarkers of SI (Chronic Liver Failure-Standard Biomarkers Composite (CLIF-SBC) score) and a gene score (CLIF-Systemic Inflammation Gene (SIG) score) composed of the 28 top differentially expressed immune cell-related genes in the comparison between high-severity and low-severity clinical phenotypes were computed. Among the 700 patients, the CLIF-SIG score was repeated once during follow-up in 375 patients, and 3 times or more in 46 patients.
RESULTS: The CLIF-SIG score was more accurate in reflecting clinical severity induced by SI than the CLIF-SBC score (area under the curve 0.803 vs 0.658). A CLIF-SIG score of 0.386 (Youden Index) was the best cut-off level discriminating patients with poor outcomes from the others, in all clinical scenarios. Sequential measurement of the CLIF-SIG score showed that 78% of patients were admitted at the peak or descending part of the SI-wave. ACLF developed during hospitalisation in 80% of patients with a CLIF-SIG score >0.386 on admission.
CONCLUSIONS: In patients with ADC, the CLIF-SIG score is an accurate estimator of SI, clinical course severity and prognosis.