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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2021.tde-06122021-145808
Document
Author
Full name
Marcelo Lourencini Puga
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2021
Supervisor
Committee
Martins, Maria Auxiliadora (President)
Basile Filho, Anibal
Nogueira, Raquel Ferraz
Rodrigues, Rodrigo do Tocantins Calado de Saloma
Title in Portuguese
Perfil longitudinal de microvesículas (MV) circulantes como biomarcador de desfecho clínico na sepse e no trauma
Keywords in Portuguese
Biomarcadores
Choque séptico
Microvesículas
Sepse
Trauma
Abstract in Portuguese
Objetivos: caracterizar o perfil de microvesículas (MV) circulantes como biomarcador de desfecho clínico na sepse e no trauma. Métodos: Foram incluídos 39 indivíduos entre 18 e 85 anos de ambos os sexos, divididos em três grupos, denominados de sepse, trauma e controle saudável, e avaliados em 4 tempos (admissão, 24h, 72h e desfecho). Resultados: Nós observamos um aumento das MV totais na sepse, e de MV derivadas de monócitos no trauma; e aumento de MV derivadas de células T e plaquetas nos dois grupos. Além disso, o grupo sepse que evoluiu ao óbito, apresentou aumento geral das MV; já no grupo trauma as MV derivadas de hemácias foram mais elevadas naqueles pacientes que evoluíram ao óbito. Quando se avalia a curva ROC de MV específicas avaliadas de acordo com o desempenho (sensibilidade e especificidade), foi encontrada acurácia de 100% para segregar o desfecho na sepse, e 95% no trauma. Conclusões: Os achados sugerem que as MV podem desempenhar papel relevante na discriminação de desfecho em pacientes com sepse e trauma com elevada acurácia.
Title in English
Performance of microvesicles (MV) as a biomarker of clinical outcome in sepsis and trauma
Keywords in English
Biomarkers
Microvesicles
Sepsis
Septic shock
Trauma
Abstract in English
Objectives: to characterize the profile of circulating microvesicles (MV) as a biomarker of clinical outcome in sepsis and trauma. Methods: 39 individuals aged between 18 and 85 of both sexes were included and divided into three groups called sepsis, trauma, and health control. They were evaluated in four stages: admission, 24h, 72h, and outcome. Results: There was an increase in total MV in sepsis, and in monocyte-derived MV in trauma. There was an increase in MV derived from T cells and platelets in both groups. In addition, the sepsis group that progressed to death had a general increase in MV; in the trauma group, the MVs derived from red blood cells were higher in the patients who died. When evaluating the ROC curve of specific MVs evaluated according to performance (sensitivity and specificity), an accuracy of 100% was found to segregate the outcome in sepsis, and 95% in trauma. Conclusions: The findings suggest that MVs can play a relevant role in discriminating the outcome in patients with sepsis and trauma with high accuracy.
 
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Publishing Date
2022-01-10
 
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