Persistently increased cell-free DNA concentrations only modestly contribute to outcome and host response in sepsis survivors with chronic critical illness
| Autor: | Philip A. Efron, Michael C. Cox, David Holden, Frederick A. Moore, Lyle L. Moldawer, Steven L. Raymond, Zhongkai Wang, Julie A. Stortz, Scott C. Brakenridge, Russell B. Hawkins |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Mitochondrial DNA Resuscitation Time Factors Critical Illness Gene Dosage 030230 surgery DNA Mitochondrial Article Tertiary Care Centers Sepsis 03 medical and health sciences 0302 clinical medicine medicine Alarmins Humans Digital polymerase chain reaction Hospital Mortality Prospective Studies Survivors Gene Aged Whole blood business.industry Middle Aged medicine.disease Nuclear DNA Intensive Care Units Treatment Outcome Cell-free fetal DNA 030220 oncology & carcinogenesis Chronic Disease Immunology Female Surgery business Cell-Free Nucleic Acids |
| Zdroj: | Surgery |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2019.11.018 |
| Popis: | Background Although early survival from sepsis has improved with timely resuscitation and source control, survivors frequently experience persistent inflammation and develop chronic critical illness. We examined whether increased copy number of endogenous alarmins, mitochondrial DNA, and nuclear DNA are associated with the early “genomic storm” in blood leukocytes and the development of chronic critical illness in hospitalized patients with surgical sepsis. Methods A prospective, observational, cohort study of critically ill septic patients was performed at a United States tertiary health care center. Blood samples were obtained at multiple time points after the onset of sepsis. Droplet Digital polymerase chain reaction (Bio-Rad Laboratories, Hercules, CA) was performed to quantify RHO (nuclear DNA) and MT-CO2 (mitochondrial DNA) copies in plasma. Leukocyte transcriptomic expression of 63 genes was also measured in whole blood. Results We enrolled 112 patients with surgical sepsis. Two experienced early death, 69 recovered rapidly, and 41 developed chronic critical illness. Both mitochondrial DNA and nuclear DNA copy number were increased in all sepsis survivors, but early nuclear DNA, and not mitochondrial DNA, copy number was further increased in patients who developed chronic critical illness. Cell-free DNA copy number was associated with in-hospital but not long-term (180-day and 365-day) mortality and were only weakly correlated with leukocyte transcriptomics. Conclusion Increased cell-free DNA copy number persists in survivors of sepsis but is not strongly associated with leukocyte transcriptomics. Nuclear DNA but not mitochondrial DNA copy number is associated with adverse, short-term, clinical trajectories and outcomes. |
| Databáze: | OpenAIRE |
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