MiR-221-3p improves the prognostic value of lung ultrasound score in acute respiratory distress syndrome and modulates the inflammatory response

Abstract Objectives Acute respiratory distress syndrome (ARDS) is linked to high mortality rates, with effective assessment of the condition critical to improving patient prognosis. The aim is to explore the value of serum miR-221-3p and lung ultrasound (LUS) score on the prognosis of ARDS, with the aim of providing meaningful references for clinical evaluation and therapeutic strategies. Methods The study cohort comprised 156 patients diagnosed with sepsis-induced ARDS. MiR-221-3p levels were quantified using RT-qPCR. Prognostic significance was determined by the ROC curve and Logistic analysis. Furthermore, a cell injury model was established in human pulmonary microvascular endothelial cells (HPMECs) induced by LPS, and the effects of miR-221-3p on cell viability and apoptosis of HPMECs were examined utilizing CCK-8 and flow cytometry. ELISA was utilized to evaluate the role of miR-221-3p on inflammatory factors and cell adhesion molecules. Results In deceased ARDS patients, elevated levels of serum miR-221-3p demonstrated a notable positive correlation with APACHE II score, SOFA score, procalcitonin, and LUS score. Notably, miR-221-3p and LUS score were identified as prognostic factors associated with patient mortality, and the integration of these two assays resulted in a more accurate assessment of patient prognoses. In HPMECs exposed to LPS, miR-221-3p silencing enhanced cell survival, suppressed apoptosis, and reduced levels of inflammatory cytokines (TNF-α, IL-6, IL-1β) and adhesion molecules (ICAM-1, E-selectin). Conclusions MiR-221-3p, combined with LUS assessment, holds prognostic value in ARDS. Its involvement in inflammation and cellular damage suggests a modulatory effect on disease advancement.