Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury

Abstract Intensive care unit (ICU)-acquired delirium is associated with adverse outcome in trauma patients with concomitant traumatic brain injury (TBI), but diagnosis remains challenging. Quantifying circadian disruption by analyzing expression of the circadian gene period circadian regulator 2 (PE...

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Autores principales:	Matti Steimer, Sandra Kaiser, Felix Ulbrich, Johannes Kalbhenn, Hartmut Bürkle, Nils Schallner
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6e99ce5c583847deabd533c9847aa968
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spelling	oai:doaj.org-article:6e99ce5c583847deabd533c9847aa9682021-12-02T16:14:35ZExpression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury10.1038/s41598-021-94773-62045-2322https://doaj.org/article/6e99ce5c583847deabd533c9847aa9682021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94773-6https://doaj.org/toc/2045-2322Abstract Intensive care unit (ICU)-acquired delirium is associated with adverse outcome in trauma patients with concomitant traumatic brain injury (TBI), but diagnosis remains challenging. Quantifying circadian disruption by analyzing expression of the circadian gene period circadian regulator 2 (PER2) and heme oxygenase 1 (HO1), which determines heme turnover, may prove to be potential diagnostic tools. Expression of PER2 and HO1 was quantified using qPCR from blood samples 1 day and 7 days after trauma. Association analysis was performed comparing mRNA expression levels with parameters of trauma (ISS—injury severity score), delirium, acute kidney injury (AKI) and length of ICU stay. 48 polytraumatized patients were included (equal distribution of TBI versus non-TBI) corrected for ISS, age and gender using a matched pairs approach. Expression levels of PER2 and HO1 were independent of age (PER2: P = 0.935; HO1: P = 0.988), while expression levels were significantly correlated with trauma severity (PER2: P = 0.009; HO1: P < 0.001) and longer ICU length of stay (PER2: P = 0.018; HO1: P < 0.001). High expression levels increased the odds of delirium occurrence (PER2: OR = 4.32 [1.14–13.87]; HO1: OR = 4.50 [1.23–14.42]). Patients with TBI showed a trend towards elevated PER2 (OR = 3.00 [0.84–9.33], P = 0.125), but not towards delirium occurrence (P = 0.556). TBI patients were less likely to develop AKI compared to non-TBI (P = 0.022). Expression levels of PER2 and HO1 correlate with the incidence of delirium in an age-independent manner and may potentially improve diagnostic algorithms when used as delirium biomarkers. Trial registration: German Clinical Trials Register (Trial-ID DRKS00008981; Universal Trial Number U1111-1172-6077; Jan. 18, 2018).Matti SteimerSandra KaiserFelix UlbrichJohannes KalbhennHartmut BürkleNils SchallnerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matti Steimer Sandra Kaiser Felix Ulbrich Johannes Kalbhenn Hartmut Bürkle Nils Schallner Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
description	Abstract Intensive care unit (ICU)-acquired delirium is associated with adverse outcome in trauma patients with concomitant traumatic brain injury (TBI), but diagnosis remains challenging. Quantifying circadian disruption by analyzing expression of the circadian gene period circadian regulator 2 (PER2) and heme oxygenase 1 (HO1), which determines heme turnover, may prove to be potential diagnostic tools. Expression of PER2 and HO1 was quantified using qPCR from blood samples 1 day and 7 days after trauma. Association analysis was performed comparing mRNA expression levels with parameters of trauma (ISS—injury severity score), delirium, acute kidney injury (AKI) and length of ICU stay. 48 polytraumatized patients were included (equal distribution of TBI versus non-TBI) corrected for ISS, age and gender using a matched pairs approach. Expression levels of PER2 and HO1 were independent of age (PER2: P = 0.935; HO1: P = 0.988), while expression levels were significantly correlated with trauma severity (PER2: P = 0.009; HO1: P < 0.001) and longer ICU length of stay (PER2: P = 0.018; HO1: P < 0.001). High expression levels increased the odds of delirium occurrence (PER2: OR = 4.32 [1.14–13.87]; HO1: OR = 4.50 [1.23–14.42]). Patients with TBI showed a trend towards elevated PER2 (OR = 3.00 [0.84–9.33], P = 0.125), but not towards delirium occurrence (P = 0.556). TBI patients were less likely to develop AKI compared to non-TBI (P = 0.022). Expression levels of PER2 and HO1 correlate with the incidence of delirium in an age-independent manner and may potentially improve diagnostic algorithms when used as delirium biomarkers. Trial registration: German Clinical Trials Register (Trial-ID DRKS00008981; Universal Trial Number U1111-1172-6077; Jan. 18, 2018).
format	article
author	Matti Steimer Sandra Kaiser Felix Ulbrich Johannes Kalbhenn Hartmut Bürkle Nils Schallner
author_facet	Matti Steimer Sandra Kaiser Felix Ulbrich Johannes Kalbhenn Hartmut Bürkle Nils Schallner
author_sort	Matti Steimer
title	Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
title_short	Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
title_full	Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
title_fullStr	Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
title_full_unstemmed	Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury
title_sort	expression of ho1 and per2 can predict the incidence of delirium in trauma patients with concomitant brain injury
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6e99ce5c583847deabd533c9847aa968
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Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury

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