Download PDF
J Pediatr Infect Dis 2024; 19(06): 354-359
DOI: 10.1055/s-0044-1791522
Original Article

Deregulated Expression of Long Non-coding RNA ZFAS1 as a Predictive Biomarker for Respiratory Failure in Severe Pneumonia Children and Its Impact on Clinical Outcome

Huaying Zhu
1   Department of Radiological Nursing, Shaoxing Second Hospital Medical Community General Hospital, Shaoxing, China
,
Shandan Wang 
2   Department of Neonatology, Zhuji Maternal and Child Health Hospital, Zhuji, China
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective Severe pneumonia is a common pediatric disease, often complicated by respiratory failure (RF). The expression changes of long non-coding RNA zinc finger antisense 1 (ZFAS1) were examined in children with severe pneumonia, as well as their predictive value in the occurrence of RF and poor outcomes.

Methods A total of 120 children with severe pneumonia were included, 60 of whom had RF. RT-qPCR was used to detect mRNA levels. Deaths during the follow-up period were recorded through a 28-day follow-up survey. Receiver operating characteristic (ROC) curve and Kaplan Meier (K-M) plot were drawn to display diagnostic and predictive values, with the help of multiple logistic and Cox regression analysis.

Results A sharp rise of serum ZFAS1 was tested in severe pneumonia children, providing a area under the receiver operator characteristic curve (AUC-ROC) of 0.920, with a sensitivity of 81.67% and a specificity of 90.00%. Serum ZFAS1 (OR = 5.832, 95% CI = 2.283–14.899) was found to be associated with the occurrence of RF after adjusting other clinical indexes, with an AUC-ROC of 0.843. ZFAS1 (HR = 4.624, 95% CI = 1.318–16.217, P < 0.05) was an independent influence factor for the poor prognosis. Cases with high ZFAS1 levels had worse clinical outcomes.

Conclusion Monitoring serum ZFAS1 levels is helpful in assessing severe pneumonia in children, especially for early identification of cases with RF. High serum ZFAS1 levels have a certain predictive value for poor prognosis in patients.

Keywords

ZFAS1 - severe pneumonia - respiratory failure - predictive value


Publication History

Received: 12 May 2024

Accepted: 01 September 2024

Article published online:
04 October 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 He J, Yuan R, Cui X. et al. Anemoside B4 protects against Klebsiella pneumoniae- and influenza virus FM1-induced pneumonia via the TLR4/Myd88 signaling pathway in mice. Chin Med 2020; 15: 68
    CrossrefPubMedGoogle Scholar
  • 2 Huang C, Zhang C, Zhang J, Zhang L, Mo Y, Mo L. Heparin-binding protein in critically ill children with severe community-acquired pneumonia. Front Pediatr 2021; 9: 759535
    CrossrefPubMedGoogle Scholar
  • 3 Rueda ZV, Aguilar Y, Maya MA. et al. Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents. BMC Pediatr 2022; 22 (01) 169
    CrossrefPubMedGoogle Scholar
  • 4 Li W, An X, Fu M, Li C. Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports. Exp Ther Med 2016; 12 (04) 2145-2149
    PubMedGoogle Scholar
  • 5 Wang L, Fan Y, Xu J, Deng H, Geng C, Jia B. The efficacy and safety of Tanreqing injection combined with western medicine for severe pneumonia: a protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99 (35) e22010
    CrossrefPubMedGoogle Scholar
  • 6 Hirota K. Preoperative management and postoperative delirium: the possibility of neuroprehabilitation using virtual reality. J Anesth 2020; 34 (01) 1-4
    CrossrefPubMedGoogle Scholar
  • 7 de Vasconcelos MGGC, Jarovsky D, Nunes GZ, Tridente DM, Grill JAT, Berezin EN. Molecular diagnostic of complicated pneumonia in the post-vaccine era. J Trop Pediatr 2022; 68 (06) fmac086
    CrossrefPubMedGoogle Scholar
  • 8 Munro APS. Molecular diagnostics for invasive lung infections in children. Acta Paediatr 2023; 112 (07) 1368-1370
    CrossrefPubMedGoogle Scholar
  • 9 Bridges MC, Daulagala AC, Kourtidis A. LNCcation: lncRNA localization and function. J Cell Biol 2021; 220 (02) e202009045
    CrossrefPubMedGoogle Scholar
  • 10 Cui J, Wang J, Lv Y, Xu D. LncRNA NEAT1 regulates infantile pneumonia by sponging miR-146b. Mol Biotechnol 2021; 63 (08) 694-701
    CrossrefPubMedGoogle Scholar
  • 11 Sun J, Mao S, Ji W. LncRNA H19 activates cell pyroptosis via the miR-22-3p/NLRP3 axis in pneumonia. Am J Transl Res 2021; 13 (10) 11384-11398
    PubMedGoogle Scholar
  • 12 Zhang P, Cao L, Zhou R, Yang X, Wu M. The lncRNA Neat1 promotes activation of inflammasomes in macrophages. Nat Commun 2019; 10 (01) 1495
    CrossrefPubMedGoogle Scholar
  • 13 Zhou C, Wu D. Abnormal expression of lncRNA CASC9 in pneumonia children with respiratory failure and its feasible value for the clinical diagnosis of patients. Cell Cycle 2022; 21 (17) 1879-1886
    CrossrefPubMedGoogle Scholar
  • 14 Chen X, Liu Q, Chen J, Liu Y. LncRNA RP11-248E9.5 and RP11-456D7.1 are valuable for the diagnosis of childhood pneumonia. Int J Gen Med 2021; 14: 895-902
    CrossrefPubMedGoogle Scholar
  • 15 Chen P, Huang Z, Chen L. et al. The relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia in children. Sci Rep 2021; 11 (01) 2059
    CrossrefPubMedGoogle Scholar
  • 16 Wu W, Zhong W, Xu Q, Yan J. Silencing of long non-coding RNA ZFAS1 alleviates LPS-induced acute lung injury by mediating the miR-96-5p/OXSR1 axis in sepsis. Am J Med Sci 2022; 364 (01) 66-75
    CrossrefPubMedGoogle Scholar
  • 17 Yang Y, Tai W, Lu N. et al. lncRNA ZFAS1 promotes lung fibroblast-to-myofibroblast transition and ferroptosis via functioning as a ceRNA through miR-150-5p/SLC38A1 axis. Aging (Albany NY) 2020; 12 (10) 9085-9102
    CrossrefPubMedGoogle Scholar
  • 18 Subspecialty Group of Respiratory Diseases TSoPCMA. Editorial Board CJoP. [Guidelines for management of community acquired pneumonia in children (the revised edition of 2013) (I)] [in Chinese]. Zhonghua Er Ke Za Zhi 2013; 51 (10) 745-752
    PubMedGoogle Scholar
  • 19 Zhou P, Li Z, Gao L. et al. Pulmonary involvement of ANCA-associated vasculitis in adult Chinese patients. BMC Pulm Med 2022; 22 (01) 35
    CrossrefPubMedGoogle Scholar
  • 20 Zheng HH, Xiang Y, Wang Y, Zhao QS, Fang R, Dai R. Clinical value of blood related indexes in the diagnosis of bacterial infectious pneumonia in children. Transl Pediatr 2022; 11 (01) 114-119
    CrossrefPubMedGoogle Scholar
  • 21 Ning J, Shao X, Ma Y, Lv D. Valuable hematological indicators for the diagnosis and severity assessment of Chinese children with community-acquired pneumonia: prealbumin. Medicine (Baltimore) 2016; 95 (47) e5452
    CrossrefPubMedGoogle Scholar
  • 22 Ni J, Lu J, Lu D. Abnormal expression and clinical value analysis of long noncoding RNA cancer susceptibility candidate 2 in children with severe pneumonia complicated with respiratory failure. Clin Respir J 2022; 16 (06) 460-466
    CrossrefPubMedGoogle Scholar
  • 23 Tang X, Yin R, Shi H. et al. LncRNA ZFAS1 confers inflammatory responses and reduces cholesterol efflux in atherosclerosis through regulating miR-654-3p-ADAM10/RAB22A axis. Int J Cardiol 2020; 315: 72-80
    CrossrefPubMedGoogle Scholar
  • 24 Yang S, Yin W, Ding Y, Liu F. Lnc RNA ZFAS1 regulates the proliferation, apoptosis, inflammatory response and autophagy of fibroblast-like synoviocytes via miR-2682-5p/ADAMTS9 axis in rheumatoid arthritis. Biosci Rep 2020; 40 (08) BSR20201273
    CrossrefPubMedGoogle Scholar
  • 25 He C, Su C, Zhang W. et al. Modulatory potential of lncRNA Zfas1 for inflammation and neuronal apoptosis in temporal lobe epilepsy. Yonsei Med J 2021; 62 (03) 215-223
    CrossrefPubMedGoogle Scholar
  • 26 Chavez-Galan L, Ruiz A, Martinez-Espinosa K. et al. Circulating levels of PD-L1, TIM-3 and MMP-7 are promising biomarkers to differentiate COVID-19 patients that require invasive mechanical ventilation. Biomolecules 2022; 12 (03) 445
    CrossrefPubMedGoogle Scholar
  • 27 Niu BY, Wang G, Li B, Zhen GS, Weng YB. Sequential treatment of severe pneumonia with respiratory failure and its influence on respiratory mechanical parameters and hemodynamics. World J Clin Cases 2022; 10 (21) 7314-7323
    CrossrefPubMedGoogle Scholar
  • 28 Guo J, Zhang N, Liu G, Zhang A, Liu X, Zheng J. Upregulated expression of long non-coding RNA MEG3 serves as a prognostic biomarker in severe pneumonia children and its regulatory mechanism. Bioengineered 2021; 12 (01) 7120-7131
    CrossrefPubMedGoogle Scholar
  • 29 Li W, An X, Fu M, Li C. Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports. Exp Ther Med 2016; 2022 (04) 2145-2149
    CrossrefPubMedGoogle Scholar
  • 30 Chama M, Amadi BC, Chandwe K. et al. Transcriptomic analysis of enteropathy in Zambian children with severe acute malnutrition. EBioMedicine 2019; 45: 456-463
    CrossrefPubMedGoogle Scholar
  • 31 Guo S, Mao X, Liang M. The moderate predictive value of serial serum CRP and PCT levels for the prognosis of hospitalized community-acquired pneumonia. Respir Res 2018; 19 (01) 193
    CrossrefPubMedGoogle Scholar