Dissecting Inflammatory Complications in Critically Injured Patients by Within-Patient Gene Expression Changes: A Longitudinal Clinical Genomics Study
2011

Understanding Gene Expression Changes in Trauma Patients

Sample size: 168 publication 10 minutes Evidence: high

Author Information

Author(s): Keyur H. Desai, Chuen Seng Tan, Jeffrey T. Leek, Ronald V. Maier, Ronald G. Tompkins, John D. Storey

Primary Institution: Princeton University

Hypothesis

Can early gene expression changes predict long-term complications in trauma patients?

Conclusion

The study identifies specific gene expression changes that are associated with longer-term complications in trauma patients, which could improve outcome predictions.

Supporting Evidence

  • A quarter of the genome shows early expression changes associated with longer-term post-injury complications.
  • Early down-regulation of MHC-class II genes and up-regulation of p38 MAPK signaling pathway were found to strongly associate with longer-term complications.
  • The study developed a statistical framework to model early within-patient expression changes.

Takeaway

Doctors studied how genes change in trauma patients to figure out who might get worse later. They found some important clues in the genes that could help treat these patients better.

Methodology

The study followed 168 trauma patients for 28 days, measuring clinical variables and gene expression using microarrays.

Potential Biases

There was no physician or severity of illness bias in the sample collection process.

Limitations

Gene expression was measured in total blood leukocytes, which may confound results due to changes in individual leukocyte subpopulations.

Participant Demographics

Patients aged 16-55 years, with 107 males and 61 females.

Statistical Information

P-Value

p<0.0001

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.1001093

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