LncRNA GAS5 relates to Th17 cells and serves as a potential biomarker for sepsis inflammation, organ dysfunctions and mortality risk

BACKGROUND: Long noncoding RNA GAS5 (lnc‐GAS5) is able to regulate macrophage M1 polarization and Th17 cell differentiation, also engaged in sepsis‐induced inflammation and organ injury. This study aimed to further evaluate its linkage with Th1 cells and Th17 cells, as well as its clinical value in sepsis management. METHODS: About 101 sepsis patients were enrolled followed by peripheral blood mononuclear cell (PBMC) and serum samples collection. PBMC lnc‐GAS5 was detected by RT‐qPCR; Th1 cells and Th17 cells in PBMC CD4(+) T cells were detected by flow cytometry; serum IFN‐γ and IL‐17A were detected by ELISA. Besides, PBMC lnc‐GAS5 was also detected in 50 health controls (HCs). RESULTS: Lnc‐GAS5 was reduced in sepsis patients than in HCs (p < 0.001), which also well‐distinguished sepsis patients from HCs with AUC 0.860. Lnc‐GAS5 did not relate to Th1 cells (p = 0.059) or IFN‐γ (p = 0.192); while negatively linked with Th17 cells (p = 0.002) and IL‐17A (p = 0.019) in sepsis patients. Interestingly, lnc‐GAS5 negatively correlated with SOFA score (p = 0.001), SOFA‐Respiratory system score (p = 0.001), SOFA‐Coagulation score (p = 0.015), and SOFA‐Renal system score (p = 0.026), but not SOFA‐Liver score (p = 0.080), SOFA‐Cardiovascular system score (p = 0.207) or SOFA‐Nervous system score (p = 0.182) in sepsis patients. Furthermore, lnc‐GAS5 was negatively related to CRP (p = 0.002) and APACHE II score (p = 0.004) in sepsis patients. Finally, lnc‐GAS5 was decreased in dead sepsis patients compared to survivors (p = 0.007), which also distinguished sepsis deaths from survivors with AUC 0.713. CONCLUSION: Lnc‐GAS5 relates to Th17 cells and serves as a potential biomarker for sepsis severity and mortality risk.