Prediction of postoperative delirium by blood metabolome analysis

IF 3.7 2区 医学 Q1 PSYCHIATRY
Naohiro Arai , Yuki Sugiura , Shinichiro Nakajima , Masataka Wada , Sotaro Moriyama , Yu Mimura , Kanta Niinomi , Kousuke Takayama , Rae Maeda , Seri Kitada , Sidonia Fagarasan , Masaki Tajima , Shuken Boku , Minoru Takebayashi , Jungo Kato , Minoru Kitago , Yuko Kitagawa , Tatsuo Takahashi , Hideyuki Shimizu , Hiroyuki Uchida , Yoshihiro Noda
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Abstract

No established blood markers can preoperatively predict postoperative delirium. Blood concentrations of amino acid catabolites and dipeptides, including those secreted extracellularly during T-lymphocyte activation, were investigated as predictors of postoperative delirium using metabolomic analyses to ascertain whether preoperative blood metabolites could predict postoperative delirium. Eighteen and 24 participants were included in the delirium and non-delirium groups, respectively. Higher preoperative levels of amino acid (tryptophan) catabolites, via the indoleamine 2,3-dioxygenase pathway, were observed in the delirium group and identified as potential predictors of postoperative delirium in this study. The delirium group had preoperatively elevated levels of tryptophan catabolites and only a limited increase postoperatively, suggesting that the tryptophan catabolic pathway may be activated preoperatively in patients at high risk of delirium. Non-targeted metabolomic analysis found a set of preoperatively elevated γ-glutamyl dipeptides as potential predictors of postoperative delirium. In vitro experiments showed that T-cell-receptor stimulation increases tryptophan metabolism and specific γ-glutamyl dipeptide secretion, offering a possible explanation for the increased levels of metabolites in postoperative delirium. This study showed that levels of amino acid metabolites associated with blood immune activity may have the potential to predict postoperative delirium.

Abstract Image

血液代谢组学分析预测术后谵妄
术前没有确定的血液指标可以预测术后谵妄。通过代谢组学分析,研究了血液中氨基酸分解代谢物和二肽的浓度,包括t淋巴细胞活化过程中细胞外分泌的氨基酸和二肽,作为术后谵妄的预测因子,以确定术前血液代谢物是否可以预测术后谵妄。谵妄组和非谵妄组分别有18名和24名参与者。通过吲哚胺2,3-双加氧酶途径,在谵妄组中观察到较高的术前氨基酸(色氨酸)分解代谢物水平,并在本研究中确定为术后谵妄的潜在预测因素。谵妄组术前色氨酸分解代谢水平升高,术后仅有限升高,提示在谵妄高危患者中,色氨酸分解代谢途径可能在术前被激活。非靶向代谢组学分析发现,一组术前升高的γ-谷氨酰二肽是术后谵妄的潜在预测因素。体外实验表明,t细胞受体刺激增加色氨酸代谢和特异性γ-谷氨酰二肽分泌,可能解释了术后谵妄代谢产物水平升高的原因。这项研究表明,与血液免疫活性相关的氨基酸代谢物水平可能具有预测术后谵妄的潜力。
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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