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Open Access 01-12-2020 | Acute Respiratory Distress-Syndrome | Research article

Serum heme oxygenase-1 measurement is useful for evaluating disease activity and outcomes in patients with acute respiratory distress syndrome and acute exacerbation of interstitial lung disease

Authors: Ryo Nagasawa, Yu Hara, Kota Murohashi, Ayako Aoki, Nobuaki Kobayashi, Shigeto Takagi, Satoru Hashimoto, Akihiko Kawana, Takeshi Kaneko

Published in: BMC Pulmonary Medicine | Issue 1/2020

Abstract

Background

Oxidative stress plays an important role in acute lung injury, which is associated with the development and progression of acute respiratory failure. Here, we investigated whether the degree of oxidative stress as indicated by serum heme oxygenase-1 (HO-1) is clinically useful for predicting prognosis among the patients with acute respiratory distress syndrome (ARDS) and acute exacerbation of interstitial lung disease (AE-ILD).

Methods

Serum HO-1 levels of newly diagnosed or untreated ARDS and AE-ILD patients were measured at diagnosis. Relationships between serum HO-1 and other clinical parameters and 1 and 3-month mortality were evaluated.

Results

Fifty-five patients including 22 of ARDS and 33 of AE-ILD were assessed. Serum HO-1 level at diagnosis was significantly higher in ARDS patients than AE-ILD patients (87.8 ± 60.0 ng/mL vs. 52.5 ± 36.3 ng/mL, P < 0.001). Serum HO-1 correlated with serum total bilirubin (R = 0.454, P < 0.001) and serum LDH (R = 0.500, P < 0.001). In both patients with ARDS and AE-ILDs, serum HO-1 level tended to decrease from diagnosis to 2 weeks after diagnosis, however, did not normalized. Composite parameters including serum HO-1, age, sex, and partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F) ratio for prediction of 3-month mortality showed a higher AUC (ARDS: 0.925, AE-ILDs: 0.892) than did AUCs of a single predictor or combination of two or three predictors.

Conclusion

Oxidative stress assessed by serum HO-1 is persistently high among enrolled patients for 2 weeks after diagnosis. Also, serum HO-1 levels at the diagnosis combined with age, sex, and P/F ratio could be clinically useful for predicting 3-month mortality in both ARDS and AE-ILD patients.

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Title: Serum heme oxygenase-1 measurement is useful for evaluating disease activity and outcomes in patients with acute respiratory distress syndrome and acute exacerbation of interstitial lung disease
Authors: Ryo Nagasawa
Yu Hara
Kota Murohashi
Ayako Aoki
Nobuaki Kobayashi
Shigeto Takagi
Satoru Hashimoto
Akihiko Kawana
Takeshi Kaneko
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Acute Respiratory Distress-Syndrome
Published in: BMC Pulmonary Medicine / Issue 1/2020
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/s12890-020-01341-1

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Methods

Results

Conclusion

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