title: Genomic and proteomic determinants of outcome in patients undergoing thoracoabdominal aortic aneurysm repair.
abstract: Thoracoabdominal aortic aneurysm repair, with its requisite intraoperative mesenteric ischemia-reperfusion, often results in the development of systemic inflammatory response syndrome, multiorgan dysfunction syndrome (MODS), and death. In the present study, an adverse clinical outcome following thoracoabdominal aortic aneurysm repair was identified by blood leukocyte genomic and plasma proteomic responses. Time-dependent changes in the expression of 146 genes from blood leukocytes were observed (p < 0.001). Expression of 138 genes (p < 0.001) and the concentration of seven plasma proteins discriminated between patients who developed MODS and those who did not, and many of these differences were evident even before surgery. These findings suggest that changes in blood leukocyte gene expression and plasma protein concentrations can illuminate pathophysiological processes that are subsequently associated with the clinical sequelae of systemic inflammatory response syndrome and MODS. These changes in gene expression and plasma protein concentrations are often observed before surgery, consistent with either a genetic predisposition or pre-existing inflammatory state.
authors.affiliation: Department of Surgery, University of Florida College of Medicine, Gainesville, FL 32610, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Feezor
authors.forename: Henry V
authors.initials: HV
authors.lastname: Baker
authors.forename: Wenzhong
authors.initials: W
authors.lastname: Xiao
authors.forename: W Anthony
authors.initials: WA
authors.lastname: Lee
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Huber
authors.forename: Michael
authors.initials: M
authors.lastname: Mindrinos
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Kim
authors.forename: Laurence
authors.initials: L
authors.lastname: Ruiz-Taylor
authors.forename: Lyle L
authors.initials: LL
authors.lastname: Moldawer
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Davis
authors.forename: James M
authors.initials: JM
authors.lastname: Seeger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001798:Blood Proteins / Q000032:analysis*; D005260:Female; D020869:Gene Expression Profiling; D016678:Genome; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D040901:Proteomics; D016896:Treatment Outcome
chemical_list: D001798:Blood Proteins