Elevated soluble death receptor 5 can predict poor prognosis in patients with acute respiratory distress syndrome

ABSTRACT

Background

The tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) and its receptor, death receptor 5 (DR5), participate in pulmonary cell apoptosis. This study aimed to investigate the clinical value of soluble DR5 and TRAIL for prognosis assessment in acute respiratory distress syndrome (ARDS).

Research design and methods

Serum and bronchoalveolar lavage fluid (BALF) samples were collected from ARDS patients and controls. Patients were followed-up until death or discharge. Soluble DR5, TRAIL, TNF-α, soluble receptor for advanced glycation end-products (sRAGE), and albumin levels were measured using the Magnetic Luminex or enzyme-linked immunosorbent assays. Data were analyzed according to their distributions and statistical purposes.

Results

Serum and BALF DR5 levels were elevated in patients with ARDS; TRAIL elevation and reduction was observed in BALF and serum, respectively. Serum DR5 was higher in non-survivors compared to survivors. Serum DR5 was positively correlated with serum TNF-α and critical illness scores and negatively correlated with serum TRAIL. Serum DR5 exhibited potential for predicting mortality in patients with ARDS.

Conclusions

Serum soluble DR5 elevation, a valuable prognosis predictor in ARDS, may be associated with alveolar epithelial cell apoptosis.

Trial Registration

http://www.chictr.org.cn/index.aspx.Uniqueidentifier:ChiCTR-DDD-17013370.

Article highlights

• Serum and BALF soluble DR5 levels were elevated in patients with ARDS

• Soluble DR5 levels were correlated with TNF-α, TRAIL, soluble RAGE, and lung fluid leakage.

• Serum soluble DR5 was higher in non-survivors than that in survivors

• Serum soluble DR5 was valuable in predicting the prognosis of patients with ARDS.

Author contributions

All the authors contributed to perform this research are listed below with their specific role in brief: Fuqiang Wen, Tao Wang, Jiangyue Qin and Hao Wang conceived the original idea and designed the study. Jiangyue Qin, Hao Wang, Zhuoyao Lyu, Yue Liao, Ni Zeng, Ke Wang, Yongfang Zhou, Zijian Zeng, Zenglin Liao, Yufang Cao and Junyun He took part in sample and data collection for the study. The data analysis, manuscript drafting and experimental testing were performed by Jiangyue Qin and Hao Wang. The manuscript was revised by Fuqiang Wen and Tao Wang. All authors reviewed the manuscript and gave the final approval for submission.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from Expert Review of Respiratory Medicine for their review work, but have no other relevant financial relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17476348.2022.2100351

Additional information

Funding

This work was supported by the 1.3.5 project for disciplines of excellence, the National Natural Science Foundation of China (NSFC) under Grant numbers 81900080 and 81600055; the Key Research and Development Program from Department of Science and Technology of Sichuan Province under Grant number 2020YFS0146; The Postdoctoral Foundation of Sichuan University [2019SCU12040] and West China Hospital [2019HXBH077].