Irreversible muscle loss is a rapidly emerging socio-economic and healthcare challenge, and public health priority. Muscle loss can be exacerbated during critical illness and bedrest; resulting in frailty, long-term disability, increased morbidity and mortality.
The study of microRNAs is a growing area of interest in the field of sarcopenia, frailty and aging. MiR-21 was identified by Rusanova to correlate positively with frailty, and a recent review by Dato identified ten microRNAs which offer promising capabilities for early diagnosis of frailty. Early recognition of patients at increased risk of developing frailty could personalise recovery protocols following discharge.
Preliminary work at University of Galway and UHG shows that serum levels of microRNAs with known function in skeletal muscle show strong predictive potential of long-term frailty post-COVID-19[4].
Building on this research, during this project we will examine the expression of muscle microRNAs in a cohort of patients admitted to the ICU with non-COVID-19 sepsis with an aim to determine if their expression is similar to that of COVID-19 patients, and to validate their use as predictors of frailty. Additionally, we will continue studying samples previously collected to correlate expression of microRNAs with clinically meaningful outcomes, including length of stay and mortality.
Over an 8-week period we will recruit 20-25 participants, measure serum microRNA levels throughout their time in ICU and assess for frailty both at baseline and follow-up. We expect to find that participants with elevated microRNA levels will have increased functional impairment and measurable frailty.
Hypothesis:
MicroRNAs of patients with sepsis in ICU can be used as objective biomarkers for development of frailty syndrome.
Objectives: Examine the muscle microRNA profiles of patients with sepsis in ICU and their relationship with frailty at baseline.
Validate serum biomarkers of muscle loss/frailty post-ICU sepsis admission to identify patients at high risk of long-term frailty.
