title: Metabolism gene signatures and surgical site infections in abdominal surgery.
abstract: BACKGROUND
  Surgical site infections (SSI) represent a significant cause of morbidity in abdominal surgery. The objective of this study was to determine the gene expression signature in subcutaneous tissues in relation to SSI.
  
  
  METHODS
  To determine differences in gene expression, microarray analysis were performed from bulk tissue mRNA of subcutaneous tissues prospectively collected in 92 patients during open abdominal surgery. 10 patients (11%) developed incisional (superficial and deep) SSI.
  
  
  RESULTS
  Preoperative risk factors in patients with SSI were not significantly different from those in patients without wound infections. 1025 genes were differentially expressed between the groups, of which the AZGP1 and ALDH1A3 genes were the highest down- and upregulated ones. Hierarchical clustering demonstrated strong similarity within the respective groups (SSI vs. no-SSI) indicating inter-group distinctness. In a functional classification, genes controlling cell metabolism were mostly down-regulated in subcutaneous tissues of patients that subsequently developed SSI.
  
  
  CONCLUSIONS
  Altered expression of metabolism genes in subcutaneous tissues might constitute a risk factor for postoperative abdominal SSI.
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany.
authors.forename: Bo
authors.initials: B
authors.lastname: Kong
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany; Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Bruns
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Raulefs
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Rieder
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Paul
authors.affiliation: Institute of Microbiology, Technische Universität München, Munich, Germany.
authors.forename: Olivia
authors.initials: O
authors.lastname: Prazeresda Costa
authors.affiliation: Institute of Microbiology, Technische Universität München, Munich, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Buch
authors.affiliation: Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Munich, Germany.
authors.forename: Fabian J
authors.initials: FJ
authors.lastname: Theis
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany.
authors.forename: Christoph W
authors.initials: CW
authors.lastname: Michalski
authors.affiliation: Department of Surgery, Technische Universität München, Munich, Germany. Electronic address: kleeff@tum.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleeff
mesh_terms: D000005:Abdomen; D054392:Adipokines; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000445:Aldehyde Oxidoreductases / Q000378:metabolism; D000619:Aminohydrolases / Q000378:metabolism; D002352:Carrier Proteins / Q000378:metabolism; D013505:Digestive System Surgical Procedures; D005260:Female; D005574:Formate-Tetrahydrofolate Ligase / Q000378:metabolism; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008754:Methylenetetrahydrofolate Dehydrogenase (NADP) / Q000378:metabolism; D008875:Middle Aged; D009097:Multienzyme Complexes / Q000378:metabolism; D011184:Postoperative Period; D040521:Subcutaneous Tissue / Q000378:metabolism; D013530:Surgical Wound Infection / Q000235:genetics* / Q000378:metabolism; D046888:Tissue Array Analysis; D059467:Transcriptome; D055815:Young Adult; D000090203:Zn-Alpha-2-Glycoprotein
chemical_list: D054392:Adipokines; D000445:Aldehyde Oxidoreductases; D000619:Aminohydrolases; D002352:Carrier Proteins; D005574:Formate-Tetrahydrofolate Ligase; D006023:Glycoproteins; D008754:Methylenetetrahydrofolate Dehydrogenase (NADP); D009097:Multienzyme Complexes; C488891:AZGP1 protein, human; D000090203:Zn-Alpha-2-Glycoprotein; C021836:formyl-methenyl-methylenetetrahydrofolate synthetase; C018699:aldehyde dehydrogenase (NAD(P)+)
keywords: ALDH1A3; AZGP1; Cellular metabolism; Subcutaneous tissue; Surgical site infection