Developing a Gene Expression Model for Predicting Ventilator-Associated Pneumonia in Trauma Patients A Pilot Study 英文参考文献.docVIP

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Developing a Gene Expression Model for Predicting Ventilator-Associated Pneumonia in Trauma Patients A Pilot Study 英文参考文献.doc

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Developing a Gene Expression Model for Predicting Ventilator-Associated Pneumonia in Trauma Patients A Pilot Study 英文参考文献

DevelopingaGeneExpressionModelforPredicting Ventilator-AssociatedPneumoniainTraumaPatients:A PilotStudy JosephM.Swanson1*,G.ChristopherWood1,LijingXu5,LisaE.Tang2,BerndMeibohm2, RaminHomayouni4,5,MartinA.Croce3,TimothyC.Fabian3 1DepartmentofClinicalPharmacy,TheUniversityofTennesseeHealthScienceCenter,Memphis,Tennessee,UnitedStatesofAmerica,2DepartmentofPharmaceutical Sciences,TheUniversityofTennesseeHealthScienceCenter,Memphis,Tennessee,UnitedStatesofAmerica,3DepartmentofSurgery,TheUniversityofTennesseeHealth ScienceCenter,Memphis,Tennessee,UnitedStatesofAmerica,4DepartmentofBiologicalSciences,TheUniversityofMemphis,Memphis,Tennessee,UnitedStatesof America,5BioinformaticsProgram,TheUniversityofMemphis,Memphis,Tennessee,UnitedStatesofAmerica Abstract Background:Ventilator-associatedpneumonia(VAP)carriessignificantmortalityandmorbidity.Predictingwhichpatients willbecomeinfectedcouldleadtomeasurestoreducetheincidenceofVAP. Methodology/Principal Findings: The goal was to begin constructing a model for VAP prediction in critically-injured traumapatients,andtoidentifydifferentiallyexpressedgenesinpatientswhogoontodevelopVAPcomparedtosimilar patients who do not. Gene expression profiles of lipopolysaccharide stimulated blood cells in critically injured trauma patientsthatwentontodevelopventilator-associatedpneumonia(n=10)wascomparedtothosethatneverdeveloped theinfection(n=10).Eighthundredandtengenesweredifferentiallyexpressedbetweenthetwogroups(ANOVA,P,0.05) andfurtheranalyzedbyhierarchicalclusteringandprincipalcomponentanalysis.FunctionalanalysisusingGeneOntology andKEGGclassificationsrevealedenrichmentinmultiplecategoriesincludingregulationofproteintranslation,regulationof proteaseactivity,andresponsetobacterialinfection.Alogisticregressionmodelwasdevelopedthataccuratelypredicted critically-injuredtraumapatientsthatwentontodevelopVAP(VAP+)andthosethatdidnot(VAP2).Fivegenes(PIK3R3, ATP2A1,PI3,ADAM8,andHCN4)werecommontoalltop20significantgenesthatwereidentifiedfromallind