Genomic and Proteomic Determinants of Outcome in Patients Undergoing Thoracoabdominal Aortic Aneurysm Repair

Feezor, Robert J.; Baker, Henry V.; Xiao, Wenzhong; Lee, W. Anthony; Huber, Thomas S.; Mindrinos, Michael; Kim, Raymond A.; Ruiz-Taylor, Laurence; Moldawer, Lyle L.; Davis, Ronald W.; Seeger, James M.

doi:10.4049/jimmunol.172.11.7103

Cited by 59 publications

(32 citation statements)

References 27 publications

(20 reference statements)

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“…Regarding outcome prediction and monitoring, several studies conducted in patients after surgery (171) or severe trauma (172)(173)(174) have shown promising results. We addressed this question in septic shock patients monitored after the early pro-inflammatory reaction, when the patient's immune functions are known to be severely depressed (>48 h after the onset of shock) (11).…”

Section: Toward a Genomic Approachmentioning

confidence: 99%

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Monneret

Venet

Pachot

et al. 2008

Mol Med

306

323

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Section: Toward a Genomic Approachmentioning

confidence: 99%

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Monneret

Venet

Pachot

et al. 2008

Mol Med

306

323

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“…54 Genomic and proteomic studies revealed that the levels of expression of 138 genes in peripheral blood leukocytes of patients undergoing thoracoabdominal aortic aneurysm repair and the concentrations of 7 plasma proteins discriminated between patients who developed multiorgan dysfunction syndrome and those who did not. 87 …”

Section: Cd3mentioning

confidence: 99%

Aortic Aneurysms

2008

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“…Peripheral gene expression signatures have been shown to change acutely with surgery [4], and it is possible that some combination of "baseline" and "poststress" leukocyte profiles may be proven capable of predicting patients at high risk for complications with a known inflammatory component, such as atrial fibrillation or myocardial injury. Furthermore, leukocyte activation patterns may help gain mechanistic understanding of how inflammation is involved in the process of end-organ dysfunction (e.g., humorally mediated or cytotoxicity).…”

Section: How Do We Study Patients In the Perioperative Period?mentioning

confidence: 99%

Understanding the Transition to Acute Illness: The Promise of Perioperative Genomics

Turer

Schwinn

2008

J. of Cardiovasc. Trans. Res.

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Over the last decades, tremendous advances have been made in understanding the genomic basis of a large number of chronic human diseases. Such advances were made possible by studying large numbers of patients over relatively long periods of time. It is increasingly recognized that acute robust stress stimulates pathways activated in chronic disease, facilitating mechanistic studies in much shorter time frames. A new field of molecular medicine, called perioperative genomics, uses robust surgical stress as a perturbation designed to explore such mechanisms. This new field is described briefly below. KeywordsPerioperative Care; Genomics; Risk Assessment; Postoperative Complications; Acute Disease Importance of the Perioperative PeriodMore than 40 million patients undergo surgery in the United States each year, and that number is expected to rise by 25% by 2020 [1]. In terms of monetary costs, the numbers are staggering with current estimates of $450 billion spent annually in the perioperative period [2]. Adverse events such as perioperative myocardial injury, renal failure, cognitive dysfunction, and stroke are devastating. Cardiovascular complications can occur after procedures even in patients without known heart disease. This problem is increasing as the population ages and cardiac risk factors, such as hypertension and diabetes mellitus, become more prevalent.Outside of its overall economic impact, the perioperative period provides an ideal model of acute illness. Although a dynamic and complicated environment, the operating room offers unique advantages for studying patients. In this environment, physiologic changes from baseline with robust stress can be prospectively quantified (e.g., hemo-dynamic parameters or plasma biomarkers). Even perturbations such as drug administration and organ ischemic time can be studied. Exposure to extremes of physiology offers the advantage of revealing (uncovering) phenotypes which might otherwise be dormant or take years to be expressed. Indeed, for patients at risk for proinflammatory activation, the operating room may transition an otherwise healthy individual into one who is acutely ill and at risk for postoperative complications and organ dysfunction.Coronary thrombosis is one example of how perioperative genomics can aid our understanding of illness beyond the operating room. There are more than one million spontaneous myocardial infarctions annually in the United States, but despite this incidence, molecular events triggering

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Genomic and Proteomic Determinants of Outcome in Patients Undergoing Thoracoabdominal Aortic Aneurysm Repair

Cited by 59 publications

References 27 publications

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Aortic Aneurysms

Understanding the Transition to Acute Illness: The Promise of Perioperative Genomics

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