Preoperative protein profiles in cerebrospinal fluid in elderly hip fracture patients at risk for delirium: A proteomics and validation study

Autor: Corneli van Aalst, Dunja Westhoff, Leo Koenderman, Piet Eikelenboom, Jos F. M. de Jonghe, Rikie M. Scholtens, Barbara C. van Munster, Joost Witlox, Diederik van de Beek, Sophia E. de Rooij, Alexander P. J. Houdijk, Willem A. van Gool, David J. van Westerloo
Přispěvatelé: Amsterdam Neuroscience, Graduate School, Neurology, Other Research, Geriatrics, Other departments, Amsterdam institute for Infection and Immunity, Molecular Neuroscience and Ageing Research (MOLAR), Psychiatry, EMGO - Mental health
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: BBA clinical, 4, 115-122. Elsevier BV
BBA Clinical, 4, 115. Elsevier B.V.
Westhoff, D, Witlox, J, van der Aalst, C, Scholtens, R M, Rooij, S E, van Munster, B C, de Jonghe, J F M, Houdijk, A P J, Eikelenboom, P, van Westerloo, D J, van de Beek, D, van Gool, W A & Koenderman, L 2015, ' Preoperative protein profiles in cerebrospinal fluid in elderly hip fracture patients at risk for delirium: A proteomics and validation study ', Bba clinical, vol. 4, pp. 115-122 . https://doi.org/10.1016/j.bbacli.2015.10.002
Clinical Journal of the American Society of Nephrology, 4, 115-122. AMER SOC NEPHROLOGY
BBA Clinical
Bba clinical, 4, 115-122. Elsevier BV
ISSN: 2214-6474
1555-9041
DOI: 10.1016/j.bbacli.2015.10.002
Popis: Background A neuroinflammatory response is suggested to play an important role in delirium, a common complication in older hospitalized patients. We examined whether hip fracture patients who develop postoperative delirium have a different proteome in cerebrospinal fluid (CSF) prior to surgery. Methods Patients (≥ 75 years) were admitted for hip fracture surgery. CSF was collected during spinal anaesthesia; proteins were separated using gel electrophoresis and identified with mass spectrometry. We compared the proteome of patients with and without postoperative delirium. Findings were validated in an independent, comparable cohort using immuno-assays. Results In the derivation cohort 53 patients were included, 35.8% developed postoperative delirium. We identified differences in levels of eight CSF proteins between patients with and without subsequent delirium: complement factor C3, contactin-1, fibulin-1 and I-beta-1,3-N-acetylglucosaminyltransferase were significantly lower in patients with postoperative delirium, while neural cell adhesion molecule-2, fibrinogen, zinc-α-2-glycoprotein and haptoglobin levels were significantly higher. In the validation cohort 21.2% of 52 patients developed postoperative delirium. Immuno-assays confirmed contactin-1 results although not statistically significant. Complement factor C3 was significantly higher in patients with postoperative delirium. Conclusion Our results show the complexity of pathophysiological mechanisms involved in delirium and emphasizes the need of independent validation of findings. General significance This study highlights the challenges and inconsistent findings in studies of delirium, a serious complication in older patients. We analysed proteins in CSF, the most proximal fluid to the brain. All patients were free from delirium at the time of sampling.
Highlights • Patients prone to delirium have different CSF protein levels. • Pathophysiological mechanisms involved in delirium are complex. • There is a need of independent validation of findings in research on delirium. • This study highlights the challenges and inconsistent findings in delirium studies.
Databáze: OpenAIRE
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