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ENGLISH ABSTRACT
唾液酸结合免疫球蛋白样凝集素-9在急性呼吸窘迫综合征患者外周血中的表达作用初探
刘晓光
陆召辉
蔡雨辰
杨展
孙学伟
朱进
苏欣
作者及单位信息
·
DOI： 10.3760/cma.j.cn112147-20240620-00350
Preliminary study on the role of siglec-9 expression in peripheral blood of acute respiratory distress syndrome patients
Liu Xiaoguang
Lu Zhaohui
Cai Yuchen
Yang Zhan
Sun Xuewei
Zhu Jin
Su Xin
Authors Info & Affiliations
Liu Xiaoguang
The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Lu Zhaohui
The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
Department of Respiratory Disease, the Second People′s Hospital of Wuhu, Wuhu 241000, China
Cai Yuchen
Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Yang Zhan
Center for Disease Control and Prevention of Eastern Theater Command, Nanjing 210002, China
Sun Xuewei
Center for Disease Control and Prevention of Eastern Theater Command, Nanjing 210002, China
Zhu Jin
Center for Disease Control and Prevention of Eastern Theater Command, Nanjing 210002, China
Su Xin
The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
Department of Respiratory and Critical Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
·
DOI： 10.3760/cma.j.cn112147-20240620-00350
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摘要

目的通过检测ARDS患者外周血中单核巨噬细胞、中性粒细胞和血浆唾液酸结合免疫球蛋白样凝集素-9（siglec-9）的表达水平，探讨其临床价值。

方法收集2021年7月至2022年10月来自南京大学医学院附属金陵医院和芜湖市第二人民医院收治的54例ARDS患者（ARDS组）临床资料和外周血样本；纳入同期住院非重症肺部感染患者（47例）作为肺部感染组，健康志愿者（50名）作为健康对照组。使用流式细胞术和ELISA分别检测细胞和血浆中siglec-9的表达水平。

结果与肺部感染组和健康对照组相比，ARDS组单核细胞和血浆siglec-9表达水平显著升高（ P<0.05），而肺部感染组和健康对照组两者单核细胞和血浆siglec-9表达水平差异无统计学意义（ P>0.05）。中重度ARDS患者血浆siglec-9水平显著高于轻度患者（ P<0.05）。多因素 logistic回归分析显示，IL-6、乳酸脱氢酶以及血浆siglec-9为发生ARDS的独立危险因素，血浆siglec-9、IL-6、APACHE Ⅱ为发生中重度ARDS患者的独立危险因素。

结论ARDS患者血浆中siglec-9表达与病情严重程度呈正相关，对ARDS病情评估具有一定的价值。

急性呼吸窘迫综合征;唾液酸结合免疫球蛋白样凝集素-9;预后
ABSTRACT

ObjectiveSialic acid-binding immunoglobulin-like lectin (siglec)-9 is a type Ⅰ transmembrane protein that plays an important role in intrinsic immunity. In this study, we examined the siglec-9 expression levels in mononuclear macrophages, neutrophils and plasma from peripheral blood of acute respiratory distress syndrome (ARDS) patients and investigated its clinical value.

MethodsPeripheral blood was obtained from ARDS patients ( n=54) admitted to the Department of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital and the Second People′s Hospital of Wuhu, Anhui Province, China, from July 2021 to October 2022. Healthy volunteers ( n=50) from the physical examination center and hospitalized patients ( n=47) with lung infection were included as control groups. The expression of cellular and plasma siglec-9 was detected by flow cytometry and ELISA separately.

ResultsCompared with lung infection group and healthy control group, the expression of monocytes and plasma siglec-9 in ARDS group increased significantly. But there was no significant difference in the expression of monocytes and plasma siglec-9 between lung infection group and healthy control group. The level of plasma siglec-9 was significantly higher in moderate-severe ARDS patients than that in mild patients ( P<0.05). Multivariable logistic regression analysis showed that IL-6, LDH and plasma siglec-9 were independent risk factors of ARDS, while plasma siglec-9, IL-6 and APACHE Ⅱ were independent risk factors of moderate-severe ARDS.

ConclusionThe expression of siglec-9 in the plasma of ARDS patients is positively correlated with the severity of ARDS, which has a certain value in the assessment of ARDS.

Acute respiratory distress syndrome;Sialic acid-binding immunoglobulin-like lectin-9;Prognosis
Su Xin, Email: mocdef.3ab61sjnixus
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引用本文

刘晓光,陆召辉,蔡雨辰,等. 唾液酸结合免疫球蛋白样凝集素-9在急性呼吸窘迫综合征患者外周血中的表达作用初探[J]. 中华结核和呼吸杂志,2025,48(02)：123-129.

DOI:10.3760/cma.j.cn112147-20240620-00350

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急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）是指肺内外严重感染、创伤、休克等多种原因导致的以急性呼吸窘迫和严重缺氧为临床表现的一种危重症，具有起病急、进展快、病死率高等特点。其中脓毒症是引发ARDS的重要诱因之一。现有的研究认为ARDS发生机制主要为过度的炎症反应形成细胞因子风暴，导致肺毛细血管内皮细胞受损，引发肺毛细血管通透性增加，最终导致肺水肿 ［ 1 , 2 , 3 , 4 , 5 ］ 。
唾液酸结合免疫球蛋白样凝集素-9（sialic acid-binding immunoglobulin-like lectin-9，siglec-9）与CD33相关，其胞外Ig结构域含有唾液酸结合位点，胞质结构域含有免疫受体酪氨酸抑制基序（immunoreceptor tyrosine-based inhibitory motif，ITIM），该基序通过募集蛋白酪氨酸磷酸酶1（SHP-1）和蛋白酪氨酸磷酸酶2（SHP-2）调节免疫细胞功能 ［ 6 , 7 , 8 ］ 。现有的研究发现，siglec-9大量表达于中性粒细胞、单核细胞、巨噬细胞、树突状细胞和NK细胞，少量表达于B细胞，而血浆中和巨噬细胞培养上清中可检测到可溶性siglec-9（ssiglec-9） ［ 9 , 10 , 11 ］ 。先前的研究表明siglec-9具有调控免疫检查点的作用。例如中性粒细胞和单核细胞中的siglec-9在产生活性氧后可诱导自身发生凋亡；在肿瘤微环境中，siglec9阻断可以显著降低体内肿瘤负荷 ［ 12 , 13 ］ 。除此之外，siglec-9激活后可抑制中性粒细胞活化，具有减轻机体炎症反应，起到免疫抑制的作用 ［ 14 ］ 。
现有的研究表明，siglec-9的表达水平与脓毒症、COVID-19和炎症性肠病密切相关，有作为炎症性疾病治疗靶点的潜力 ［ 15 ］ 。目前尚缺乏siglec-9与ARDS相关的临床研究。为此，本研究对 ARDS 患者血浆、中性粒细胞和单核细胞中的siglec-9表达水平进行了检测，并探讨siglec-9表达水平对ARDS 患者病情评估和预后预测的价值，旨在为 ARDS 的临床诊疗提供参考。
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备注信息
A
苏欣，Email： mocdef.3ab61sjnixus
B
刘晓光, 陆召辉, 蔡雨辰, 等. 唾液酸结合免疫球蛋白样凝集素-9在急性呼吸窘迫综合征患者外周血中的表达作用初探[J]. 中华结核和呼吸杂志, 2025, 48(2): 123-129. DOI: 10.3760/cma.j.cn112147-20240620-00350.
C
所有作者声明无利益冲突
D
国家自然科学基金 (82270019)
南京鼓楼医院临床研究专项 (2023-LCYJ-MS-18)
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