ABSTRACT. The purpose of this study was to identify critical genes associated with septic multiple trauma by comparing peripheral whole blood samples from multiple trauma patients with and without sepsis. A microarray data set was downloaded from the Gene Expression Omnibus (GEO) database. This data set included 70 samples, 36 from multiple trauma patients with sepsis and 34 from multiple trauma patients without sepsis (as a control set). The data were preprocessed, and differentially expressed genes (DEGs) were then screened for using packages of the R language. Functional analysis of DEGs was performed with DAVID. Interaction networks were then established for the most up-and downregulated genes using HitPredict. Pathway-enrichment analysis was conducted for genes in the networks using WebGestalt. Fifty-eight DEGs were identified. The expression levels of PLAU (down-regulated) and MMP8 (up-regulated) presented the largest fold-changes, and interaction networks were established for these genes. Further analysis revealed that PLAT (plasminogen activator, tissue) and SERPINF2 (serpin peptidase inhibitor, clade F, member 2), which interact with PLAU, play important roles in the pathway of the component and coagulation cascade. We hypothesize that PLAU is a major regulator of the component and coagulation cascade, and down-regulation of PLAU results in dysfunction of the pathway, causing sepsis.

BackgroundIn recent decades, the serum lipid profile of apolipoprotein(a) (Lp(a)) level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/ApoA1) ratio were found more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the serum lipid levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were found associated with symptomatic IDH, no studies have been conducted to date for the evaluation of the association of Apo AI, Apo B, Lp(a) and Apo B/Apo AI levels with symptomatic IDH.MaterialsA total of 1,839 Chinese patients were recruited in the present study. 918 patients were diagnosed as IDH cases and were enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B and Apo B/Apo AI were examined and analyzed.ResultsThe patients in the control group were collected randomly from patients who were matched with the baseline levels of the aforementioned lipid molecular. The patients with IDH exhibited significantly higher TC, TG, LDL, Apo B and Lp(a) levels compared with the control subjects. The percentage of high-TC, high-TG, high-LDL, high-Apo B and high-Lp(a) were significantly higher in the IDH group. However, hyperlipidaemia was not associated with the degenerated segment of the IDH (P=0.201). The odds ratios (OR) for the incidence of IDH with an elevated LDL-C, TC, TG, Lp(a), Apo B and Apo B/Apo AI were 1.583, 1.74, 1.62, 1.58, 1.49 and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a) and incidence of IDH was significant (R2LDL=0.017; R2TC=0.004; R2TG=0.015; R2Apo B=0.004; R2LP(a)=0.021) (P<0.05). ConclusionsThe present study suggests that elevated levels of serum TC, TG, LDL, Apo B, Lp(a) and Apo B/Apo AI are associated with a higher risk for IDH.