Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Sepsis represents the main cause of mortality at intensive care units. The mortality rate for all septic episodes is 30{u2013}50%. miRNAs profile data could be beneficial as a specific diagnostic biomarker for the diagnosis of sepsis and systemic inflammatory response syndrome. The aim of this study was to access the role of certain miRNAs (miRNA-122, miRNA-181b, miRNA-223 and miRNA-146a) in diagnosis of sepsis and assess the probability of these miRNAs in prediction of poor prognosis and mortality. This could provide a potentially novel biomarker for sepsis detection and therapeutic strategies. Patients and methods: This was a prospective case control study of patients admitted to Cairo university pediatric intensive care unit (PICU). Forty cases (age: 1-24 months), 60% males and 40% females were compared to 40 healthy controls that were matched for age and sex. In addition to routine laboratory tests, cultures from different sites and imaging were done according to their need, special blood samples were collected for determination of miRNA by quantitative real time PCR technique. Results: miRNA-122 (19.5 ±29.8) and miRNA-181b (3.5 ±1.69) were found to be very sensitive and specific in diagnosing sepsis by their up-regulation early during septic conditions (p<0.001). While miRNA-223 (0.55 ±0.28) and miRNA-146a (0.15 ±0.10) are also very specific and highly sensitive in diagnosing sepsis conditions but by their down-regulation (p<0.001). We also found that only serum level of miRNA-223 can be used for poor prognosis prediction in sepsis with sensitivity=70% and specificity=75%, while the other three miRNAs could not predict poor prognosis during sepsis

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