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Fathi P, Karkanitsa M, Rupert A, Lin A, Darrah J, Thomas FD, Lai J, Babu K, Neavyn M, Kozar R, Griggs C, Cunningham KW, Schulman CI, Crandall M, Sereti I, Ricotta E, Sadtler K. Development of a predictive algorithm for patient survival after traumatic injury using a five analyte blood panel. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.22.24306188. [PMID: 38903094 PMCID: PMC11188118 DOI: 10.1101/2024.04.22.24306188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Severe trauma can induce systemic inflammation but also immunosuppression, which makes understanding the immune response of trauma patients critical for therapeutic development and treatment approaches. By evaluating the levels of 59 proteins in the plasma of 50 healthy volunteers and 1000 trauma patients across five trauma centers in the United States, we identified 6 novel changes in immune proteins after traumatic injury and further new variations by sex, age, trauma type, comorbidities, and developed a new equation for prediction of patient survival. Blood was collected at the time of arrival at Level 1 trauma centers and patients were stratified based on trauma level, tissues injured, and injury types. Trauma patients had significantly upregulated proteins associated with immune activation (IL-23, MIP-5), immunosuppression (IL-10) and pleiotropic cytokines (IL-29, IL-6). A high ratio of IL-29 to IL-10 was identified as a new predictor of survival in less severe patients with ROC area of 0.933. Combining machine learning with statistical modeling we developed an equation ("VIPER") that could predict survival with ROC 0.966 in less severe patients and 0.8873 for all patients from a five analyte panel (IL-6, VEGF-A, IL-21, IL-29, and IL-10). Furthermore, we also identified three increased proteins (MIF, TRAIL, IL-29) and three decreased proteins (IL-7, TPO, IL-8) that were the most important in distinguishing a trauma blood profile. Biologic sex altered phenotype with IL-8 and MIF being lower in healthy women, but higher in female trauma patients when compared to male counterparts. This work identifies new responses to injury that may influence systemic immune dysfunction, serving as targets for therapeutics and immediate clinical benefit in identifying at-risk patients.
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Affiliation(s)
- Parinaz Fathi
- Section on Immunoengineering, Center for Biomedical Engineering and Technology Acceleration, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, MD 20892
- Unit for Nanoengineering and Microphysiologic Systems, NIBIB, NIH, Bethesda MD 20892
| | - Maria Karkanitsa
- Section on Immunoengineering, Center for Biomedical Engineering and Technology Acceleration, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, MD 20892
| | - Adam Rupert
- AIDS Monitoring Laboratory, Frederick National Laboratory for Cancer Research, Frederick MD
| | - Aaron Lin
- Section on Immunoengineering, Center for Biomedical Engineering and Technology Acceleration, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, MD 20892
- Unit for Nanoengineering and Microphysiologic Systems, NIBIB, NIH, Bethesda MD 20892
| | | | | | - Jeffrey Lai
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester MA 01655
| | - Kavita Babu
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester MA 01655
| | - Mark Neavyn
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester MA 01655
| | - Rosemary Kozar
- Shock Trauma Center, University of Maryland School of Medicine, Baltimore MD 21201
| | - Christopher Griggs
- Department of Emergency Medicine, Atrium Health’s Carolinas Medical Center, Charlotte NC 28203
| | - Kyle W. Cunningham
- Division of Acute Care Surgery, Atrium Health’s Carolinas Medical Center, Charlotte NC 28203
| | | | - Marie Crandall
- Department of Surgery, University of Florida College of Medicine, Jacksonville FL 33209
| | - Irini Sereti
- Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), NIH
| | - Emily Ricotta
- Epidemiology and Data Management Unit, Laboratory of Clinical Immunology and Microbiology, NIAID, NIH, Bethesda, MD 20892
- Preventative Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda MD 20814
| | - Kaitlyn Sadtler
- Section on Immunoengineering, Center for Biomedical Engineering and Technology Acceleration, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Bethesda, MD 20892
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Wang W, Liu M, Zhang M, Sun W, Zhang J, Jia L. Agaricus blazei Murill polysaccharides alleviate oxidative stress and inflammatory responses against liver and lung injury. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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