Correlation analysis of lymphocyte surface antigen and THBS1 levels with myocardial injury in sepsis patients

THBS1 levels in sepsis with myocardial injury

  • Min Wei Department of Emergency, The First Hospital of LanZhou University
  • Wuchao Wang Department of Emergency, Peking University People's Hospital
  • Dongxiao Wang Department of Critical Care Medicine, Mudan River Forestry Central Hospital of Heilongjiang Province
  • Yifei Cheng Infection Department, Peking University Shenzhen Hospital
  • Xiaoyu Liu Peking University Shenzhen Hospital
  • Limei Xiu Department of Critical Care Medicine, Chifeng Municipal Hospital of Inner Mongolia
Keywords: Sepsis, T lymphocytes, Immune function, Platelet reaction protein-1, Myocardial injury

Abstract


Objective To analyze the relationships among the surface antigens of lymphocytes in patients with sepsis, the level of thrombospondin-1 (THBS1), and myocardial injury.

Methods 360 sepsis patients who were hospitalized to our hospital between January 2023 and January 2025 were chosen. 170 patients with myocardial injury and 190 patients without myocardial injury were selected from the patient group based on whether or not they had myocardial injury. Serum THBS1 levels, immune function (CD4+, CD8+, and CD4+/CD8+), myocardial injury markers (creatine kinase MB (CK-MB), heart-type fatty acid binding protein (H-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac troponin I (cTnI)), and echocardiographic markers (left ventricular ejection fraction (LVEF), early diastolic velocity to atrial contraction velocity ratio (E/A), and cardiac output (CO)) were compared. Correlations between immune function, THBS1 levels, myocardial injury indicators, and echocardiographic markers in individuals with myocardial damage and infection were examined. To predict sepsis with myocardial infarction, the serum THBS1 value was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC).

Results While the myocardial injury group had significantly lower levels of CD8+ T cells in peripheral blood, LVEF, E/A, and CO, the nonmyocardial injury group had significantly higher levels of CD4+, CD4+/CD8+, serum THBS1, CK-MB, H-FABP, NT-proBNP, and cTnI (P<0.05). Patients with sepsis and myocardial injury had considerably higher peripheral blood CD8+ T cell counts with LVEF, E/A, and CO (P<0.05) and significantly lower counts with CK-MB, H-FABP, NT-proBNP, and cTnI (P<0.05). CK-MB, H-FABP, NT-proBNP, and cTnI were strongly positively correlated (P<0.05) with peripheral blood CD4+ and CD4+/CD8+ T cell counts, while LVEF, E/A, and CO were significantly correlated negatively (P<0.05). Serum THBS1 levels had a substantial negative correlation (P<0.05) with LVEF, E/A, and CO and a strong positive correlation (P<0.05) with CK-MB, H-FABP, NT-proBNP, and cTnI. With a sensitivity of 80.03% and specificity of 87.43%, the serum THBS1 concentration demonstrated an AUC of 0.892 (95% CI: 0.857–0.947) for predicting both sepsis and myocardial damage.

Conclusion Sepsis patients' levels of THBS1 and lymphocyte surface antigens are somewhat linked to myocardial damage, and THBS1 is anticipated to function as a biomarker for anticipating myocardial damage in sepsis patients.

References

1.Liu C, Zou Q, Tang H, Liu J, Zhang S, Fan C, Zhang J, Liu R, Liu Y, Liu R, Zhao Y, Wu Q, Qi Z, Shen Y. Melanin nanoparticles alleviate sepsis-induced myocardial injury by suppressing ferroptosis and inflammation. Bioact Mater. 2022 Dec 27;24:313-321. doi: 10.1016/j.bioactmat.2022.12.026. PMID: 36632502; PMCID: PMC9813528.
2.Zhou H, Dai Z, Li J, Wang J, Zhu H, Chang X, Wang Y. TMBIM6 prevents VDAC1 multimerization and improves mitochondrial quality control to reduce sepsis-related myocardial injury. Metabolism. 2023 Mar;140:155383. doi: 10.1016/j.metabol.2022.155383. Epub 2023 Jan 2. PMID: 36603706.
3.Xiao Y, Yu Y, Hu L, Yang Y, Yuan Y, Zhang W, Luo J, Yu L. Matrine Alleviates Sepsis-Induced Myocardial Injury by Inhibiting Ferroptosis and Apoptosis. Inflammation. 2023 Oct;46(5):1684-1696. doi: 10.1007/s10753-023-01833-2. Epub 2023 May 23. Erratum in: Inflammation. 2024 Aug;47(4):1545. doi: 10.1007/s10753-024-01976-w. PMID: 37219694.
4.She H, Tan L, Du Y, Zhou Y, Guo N, Zhang J, Du Y, Wang Y, Wu Z, Ma C, Li Q, Mao Q, Hu Y, Liu L, Li T. VDAC2 malonylation participates in sepsis-induced myocardial dysfunction via mitochondrial-related ferroptosis. Int J Biol Sci. 2023 Jun 14;19(10):3143-3158. doi: 10.7150/ijbs.84613. PMID: 37416771; PMCID: PMC10321281.
5.Pei H, Qu J, Chen J, Zhao G, Lu Z. S100A9 as a Key Myocardial Injury Factor Interacting with ATP5 Exacerbates Mitochondrial Dysfunction and Oxidative Stress in Sepsis-Induced Cardiomyopathy. J Inflamm Res. 2024 Jul 9;17:4483-4503. doi: 10.2147/JIR.S457340. Erratum in: J Inflamm Res. 2024 Jul 23;17:4921-4922. doi: 10.2147/JIR.S487243. PMID: 39006491; PMCID: PMC11246037.
6.Yang W, Cao Y, Li J, Zhang X, Liu X, Tian Y, Shan L, Yang Y. Pathogenesis and treatment strategies of sepsis-induced myocardial injury: modern and traditional medical perspectives. Int J Biol Sci. 2025 May 15;21(8):3478-3504. doi: 10.7150/ijbs.111288. PMID: 40520010; PMCID: PMC12160516.
7.Zeng N, Jian Z, Zhu W, Xu J, Fan Y, Xiao F. KLF13 overexpression protects sepsis-induced myocardial injury and LPS-induced inflammation and apoptosis. Int J Exp Pathol. 2023 Feb;104(1):23-32. doi: 10.1111/iep.12459. Epub 2022 Dec 30. PMID: 36583453; PMCID: PMC9845607.
8.Dong Y, Wei S, Liu Y, Ji X, Yin X, Wu Z, Wu S, Wang B, Wei S, Chen Y. Aspirin is associated with improved outcomes in patients with sepsis-induced myocardial injury: An analysis of the MIMIC-IV database. J Clin Anesth. 2024 Dec;99:111597. doi: 10.1016/j.jclinane.2024.111597. Epub 2024 Sep 7. PMID: 39245010.
9.Zhang L, Li B, Li W, Jiang J, Chen W, Yang H, Pan D. miR-107 Attenuates Sepsis-Induced Myocardial Injury by Targeting PTEN and Activating the PI3K/AKT Signaling Pathway. Cells Tissues Organs. 2023;212(6):523-534. doi: 10.1159/000525476. Epub 2022 Jun 17. PMID: 35717938.
10.Chen T, Ye L, Zhu J, Tan B, Yi Q, Sun Y, Xie Q, Xiang H, Wang R, Tian J, Xu H. Inhibition of Pyruvate Dehydrogenase Kinase 4 Attenuates Myocardial and Mitochondrial Injury in Sepsis-Induced Cardiomyopathy. J Infect Dis. 2024 Apr 12;229(4):1178-1188. doi: 10.1093/infdis/jiad365. PMID: 37624974.
11.Yang L, Wu C, Cui Y, Dong S. Knockdown of histone deacetylase 9 attenuates sepsis-induced myocardial injury and inflammatory response. Exp Anim. 2023 Aug 7;72(3):356-366. doi: 10.1538/expanim.22-0072. Epub 2023 Mar 13. PMID: 36927982; PMCID: PMC10435362.
12.Kang XF, Lu XL, Bi CF, Hu XD, Li Y, Li JK, Yang LS, Liu J, Ma L, Zhang JF. Xuebijing injection protects sepsis induced myocardial injury by mediating TLR4/NF-κB/IKKα and JAK2/STAT3 signaling pathways. Aging (Albany NY). 2023 Aug 30;15(16):8501-8517. doi: 10.18632/aging.204990. Epub 2023 Aug 30. PMID: 37650558; PMCID: PMC10496990.
13.Deng W, Ren G, Luo J, Gao S, Huang W, Liu W, Ye S. TRPM7 mediates endoplasmic reticulum stress and ferroptosis in sepsis-induced myocardial injury. J Bioenerg Biomembr. 2023 Jun;55(3):207-217. doi: 10.1007/s10863-023-09968-5. Epub 2023 Jun 2. PMID: 37264258.
14.Si X, Huang Z, Pan Z. Clinical effects of dexmedetomidine on patients with sepsis and myocardial injury. Medicine (Baltimore). 2024 Oct 25;103(43):e40257. doi: 10.1097/MD.0000000000040257. PMID: 39470486; PMCID: PMC11521069.
15.Fang J, Zhou Y. Protective effect and mechanism of γ-secretase inhibitor on myocardial injury in sepsis rats. Am J Transl Res. 2023 Feb 15;15(2):1017-1025. PMID: 36915749; PMCID: PMC10006822.
16.Xu KZ, Xu P, Li JJ, Zuo AF, Wang SB, Han F. Predictors and nomogram of in-hospital mortality in sepsis-induced myocardial injury: a retrospective cohort study. BMC Anesthesiol. 2023 Jul 7;23(1):230. doi: 10.1186/s12871-023-02189-8. PMID: 37420185; PMCID: PMC10327384.
17.Sidheeque Hassan V, Hanifa M, Navik U, Bali A. Exogenous fetuin-A protects against sepsis-induced myocardial injury by inhibiting oxidative stress and inflammation in mice. Fundam Clin Pharmacol. 2023 Jun;37(3):607-617. doi: 10.1111/fcp.12870. Epub 2023 Jan 25. PMID: 36647295.
18.Huang Y, Li L, Li Y, Lu N, Qin H, Wang R, Li W, Cheng Z, Li Z, Kang P, Ye H, Gao Q. Knockdown of LncRNA Lcn2-204 alleviates sepsis-induced myocardial injury by regulation of iron overload and ferroptosis. J Mol Cell Cardiol. 2024 Jul;192:79-93. doi: 10.1016/j.yjmcc.2024.05.007. Epub 2024 May 16. PMID: 38761990.
19.Bi CF, Liu J, Hao SW, Xu ZX, Ma X, Kang XF, Yang LS, Zhang JF. Xuebijing injection protects against sepsis-induced myocardial injury by regulating apoptosis and autophagy via mediation of PI3K/AKT/mTOR signaling pathway in rats. Aging (Albany NY). 2023 May 22;15(10):4374-4390. doi: 10.18632/aging.204740. Epub 2023 May 22. PMID: 37219401; PMCID: PMC10258031.
20.Sanchez PA, Obeidalla S, Kerchberger VE, Moore AR, Maddali MV, Kangelaris KN, Hendrickson CM, Evrard B, Liu KD, Bastarache JA, Matthay MA, Rogers AJ, Calfee CS. Heterogeneity in association of myocardial injury and mortality in sepsis or acute respiratory distress syndrome by subphenotype: a retrospective study. Crit Care. 2025 Aug 19;29(1):363. doi: 10.1186/s13054-025-05613-2. PMID: 40826103; PMCID: PMC12363128.
21.Yuan HJ, Xiang GH, Liu Y, Li Y, Liu WL, Wei JX, Xue YT, Hao H. Exploration and verification of the therapeutic mechanism of shenfu injection in sepsis-induced myocardial injury. PLoS One. 2025 Jan 17;20(1):e0317738. doi: 10.1371/journal.pone.0317738. PMID: 39823512; PMCID: PMC11741597.
22.Cui N, Chen Z, Yu Z, Lv X, Hu Z. PTX3 mediates PI3K/AKT/mTOR signaling to downregulate apoptosis and autophagy to attenuate myocardial injury in sepsis. PeerJ. 2024 May 20;12:e17263. doi: 10.7717/peerj.17263. PMID: 38784395; PMCID: PMC11114122.
23.Qin S, Ren YC, Liu JY, Chen WB, Fu B, Zheng J, Fu XY. ANXA1sp attenuates sepsis-induced myocardial injury by promoting mitochondrial biosynthesis and inhibiting oxidative stress and autophagy via SIRT3 upregulation. Kaohsiung J Med Sci. 2024 Jan;40(1):35-45. doi: 10.1002/kjm2.12767. Epub 2023 Oct 25. PMID: 37877496; PMCID: PMC11895643.
24.Xiao L, Xi X, Zhao M, Zhang L, Zhang K, Xu Z. Buyang huanwu decoction (BYHWD) alleviates sepsis-induced myocardial injury by suppressing local immune cell infiltration and skewing M2-macrophage polarization. Am J Transl Res. 2023 Apr 15;15(4):2389-2406. PMID: 37193167; PMCID: PMC10182506.
Published
2026/03/18
Section
Original paper