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Chen Y, Guo DZ, Zhu CL, Ren SC, Sun CY, Wang Y, Wang JF. The implication of targeting PD-1:PD-L1 pathway in treating sepsis through immunostimulatory and anti-inflammatory pathways. Front Immunol 2023; 14:1323797. [PMID: 38193090 PMCID: PMC10773890 DOI: 10.3389/fimmu.2023.1323797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
Sepsis currently remains a major contributor to mortality in the intensive care unit (ICU), with 48.9 million cases reported globally and a mortality rate of 22.5% in 2017, accounting for almost 20% of all-cause mortality worldwide. This highlights the urgent need to improve the understanding and treatment of this condition. Sepsis is now recognized as a dysregulation of the host immune response to infection, characterized by an excessive inflammatory response and immune paralysis. This dysregulation leads to secondary infections, multiple organ dysfunction syndrome (MODS), and ultimately death. PD-L1, a co-inhibitory molecule expressed in immune cells, has emerged as a critical factor in sepsis. Numerous studies have found a significant association between the expression of PD-1/PD-L1 and sepsis, with a particular focus on PD-L1 expressed on neutrophils recently. This review explores the role of PD-1/PD-L1 in immunostimulatory and anti-inflammatory pathways, illustrates the intricate link between PD-1/PD-L1 and sepsis, and summarizes current therapeutic approaches against PD-1/PD-L1 in the treatment and prognosis of sepsis in preclinical and clinical studies.
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Affiliation(s)
- Yu Chen
- School of Basic Medicine, Naval Medical University, Shanghai, China
| | - De-zhi Guo
- School of Basic Medicine, Naval Medical University, Shanghai, China
| | - Cheng-long Zhu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shi-chun Ren
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chen-yan Sun
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yi Wang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jia-feng Wang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, China
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Luo Y, Jiang Z, Gu R, Zhang X, Wei L, Zhou Y, Zhang S. Identification of new biomarkers and immune infiltration characteristics of sepsis in very low birth weight infants. BIOMOLECULES & BIOMEDICINE 2023; 23:792-801. [PMID: 37139640 PMCID: PMC10494841 DOI: 10.17305/bb.2023.8966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/23/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
Sepsis is a life-threatening condition, especially in very low birth weight (VLBW) infants, and its pathogenesis remains unclear. Effective biomarkers need to be found to diagnose and treat the disease at an early stage. The Gene Expression Omnibus (GEO) database was screened and analyzed for differentially expressed genes (DEGs) in VLBW infants with sepsis. DEGs were then analyzed for functional enrichment. A weighted gene co-expression network analysis (WCGNA) was performed to identify the key modules and genes. The optimal feature genes (OFGs) were created using three machine learning algorithms. The single-sample Gene Set Enrichment Analysis (ssGSEA) scored the degree of immune cell enrichment between septic and control patients, and the correlation between OFGs and immune cells was evaluated. A total of 101 DEGs were identified between the sepsis and control samples. DEGs were mainly associated with immune responses and inflammatory signaling pathways in the enrichment analysis. In the WGCNA analysis, the MEturquoise module was significantly correlated with sepsis in VLBW infants (cor = 0.57, P < 0.001). By intersecting OFGs derived from three machine learning algorithms, two biomarkers were identified: glycogenin 1 (GYG1) and resistin (RETN). The area under the curves of GYG1 and RETN was greater than 0.97 in the testing set. The ssGSEA indicated immune cells infiltration in septic VLBW infants, and GYG1 and RETN revealed close correlations with immune cells. New biomarkers offer promising insights into the diagnosis and treatment of sepsis in VLBW infants.
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Affiliation(s)
- Yujia Luo
- Department of NICU, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Qiantang District, Hangzhou, China
| | - Zhou Jiang
- Department of NICU, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Qiantang District, Hangzhou, China
| | - Rui Gu
- Department of NICU, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Qiantang District, Hangzhou, China
| | - Xuandong Zhang
- Department of NICU, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Qiantang District, Hangzhou, China
| | - Li Wei
- Department of NICU, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Qiantang District, Hangzhou, China
| | - Yuanyuan Zhou
- Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Songying Zhang
- Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
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Jiang Z, Luo Y, Wei L, Gu R, Zhang X, Zhou Y, Zhang S. Bioinformatic Analysis and Machine Learning Methods in Neonatal Sepsis: Identification of Biomarkers and Immune Infiltration. Biomedicines 2023; 11:1853. [PMID: 37509492 PMCID: PMC10377054 DOI: 10.3390/biomedicines11071853] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
The disease neonatal sepsis (NS) poses a serious threat to life, and its pathogenesis remains unclear. Using the Gene Expression Omnibus (GEO) database, differentially expressed genes (DEGs) were identified and functional enrichment analyses were conducted. Three machine learning algorithms containing the least absolute shrinkage and selection operator (LASSO), support vector machine recursive feature elimination (SVM-RFE), and random forest (RF) were applied to identify the optimal feature genes (OFGs). This study conducted CIBERSORT to present the abundance of immune infiltrates between septic and control neonates and assessed the relationship between OFGs and immune cells. In total, 44 DEGs were discovered between the septic and control newborns. Throughout the enrichment analysis, DEGs were primarily related to inflammatory signaling pathways and immune responses. The OFGs derived from machine learning algorithms were intersected to yield four biomarkers, namely Hexokinase 3 (HK3), Cystatin 7 (CST7), Resistin (RETN), and Glycogenin 1 (GYG1). The potential biomarkers were validated in other datasets and LPS-stimulated HEUVCs. Septic infants showed a higher proportion of neutrophils (p < 0.001), M0 macrophages (p < 0.001), and regulatory T cells (p = 0.004). HK3, CST7, RETN, and GYG1 showed significant correlations with immune cells. Overall, the biomarkers offered promising insights into the molecular mechanisms of immune regulation for the prediction and treatment of NS.
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Affiliation(s)
- Zhou Jiang
- Department of NICU, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 368 Xiasha Road, Qiantang District, Hangzhou 310016, China
| | - Yujia Luo
- Department of NICU, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 368 Xiasha Road, Qiantang District, Hangzhou 310016, China
| | - Li Wei
- Department of NICU, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 368 Xiasha Road, Qiantang District, Hangzhou 310016, China
| | - Rui Gu
- Department of NICU, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 368 Xiasha Road, Qiantang District, Hangzhou 310016, China
| | - Xuandong Zhang
- Department of NICU, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 368 Xiasha Road, Qiantang District, Hangzhou 310016, China
| | - Yuanyuan Zhou
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Songying Zhang
- Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 Qingchun East Road, Shangcheng District, Hangzhou 310016, China
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