The onset of inflammation and infection in a person recovering from a trauma such as a car accident or severe burns can be as deadly as the incident itself. New findings from Princeton University researchers who studied gene activity in trauma victims may help to predict and better treat such unexpected complications.
Princeton research reported in the Sept. 13 issue of the journal PLoS Medicine shows for the first time that people recovering from a serious injury -- regardless of age, gender or previous health -- exhibit similar gene activity as their condition changes, which doctors can use to predict and prepare for a patient's deterioration.
The Princeton researchers' evaluation of blood samples from 168 blunt-force trauma patients revealed that changes in gene activity -- or expression -- in the immune system consistently coincided with the worsening of a patient's condition. Immune system genes "express" via an outpouring of proteins to help activate and direct the cellular response to injury and viruses, bacteria or other pathogens. Two sets of genes in particular showed massive fluctuations in expression as patients developed complications and neared death.
After the researchers identified the genes that were most in step with a patient's state of health, they created a model based on gene expression that could help physicians better evaluate and treat critical patients.
"Plenty of genes were changing inside these patients as their bodies adjusted to the trauma they experienced, but we wanted to find the genes that, over time, foretold the outcome for the patient," said senior author John Storey, a Princeton associate professor of molecular biology and the Lewis-Sigler Institute for Integrative Genomics. He worked with the PLoS Medicine paper's joint first authors Keyur Desai and Chuen-Seng Tan, both postdoctoral research fellows in Storey's lab.
"We started this project three years ago with approximat
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