Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients

Postoperative cognitive dysfunction (POCD) is the undesirable complication following surgery that significantly impacts patients’ quality of life. The outcome of POCD is characterized by mental disorders, anxiety, personality changes and impaired memory. This study aimed to identify the different...

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Main Author: Noor Anisah Binti Abu Yazit
Format: Thesis
Language:en_US
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record_format uketd_dc
institution Universiti Sains Islam Malaysia
collection USIM Institutional Repository
language en_US
topic Postoperative cognitive dysfunction (POCD)
Mental disorders
Anxiety
(DEGs)
CABG
Ribonucleic acid (RNA)
Enzyme-linked immunosorbent assay (ELISA)
T-test
KIR3DL2
KIR2DS3
Cataractogenesis
ERFE
Immunoregulation
Erythroferrone protein
Receiver Operating Characteristic (ROC)
Coronary artery bypass
Coronary artery bypass -- Illinois -- Statistics
Receiver operating characteristic curves
spellingShingle Postoperative cognitive dysfunction (POCD)
Mental disorders
Anxiety
(DEGs)
CABG
Ribonucleic acid (RNA)
Enzyme-linked immunosorbent assay (ELISA)
T-test
KIR3DL2
KIR2DS3
Cataractogenesis
ERFE
Immunoregulation
Erythroferrone protein
Receiver Operating Characteristic (ROC)
Coronary artery bypass
Coronary artery bypass -- Illinois -- Statistics
Receiver operating characteristic curves
Noor Anisah Binti Abu Yazit
Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
description Postoperative cognitive dysfunction (POCD) is the undesirable complication following surgery that significantly impacts patients’ quality of life. The outcome of POCD is characterized by mental disorders, anxiety, personality changes and impaired memory. This study aimed to identify the differentially expressed genes (DEGs) in high-risk CABG patients with POCD and the level of the protein biomarker that correlates with the expressed gene. Forty-six patients scheduled for high-risk CABG procedures were selected based on inclusion and exclusion criteria. Cognitive assessments were done one day before and seven days after surgery to classify POCD. For DEGs analysis using microarray, ribonucleic acid (RNA) samples were collected from patients’ blood one day preoperative and 3 days postoperatively. A total of 16 samples from the 46 patients were selected for microarray analysis. Further, an enzyme-linked immunosorbent assay (ELISA) was conducted to determine the level of protein biomarkers related to the DEGs. Independent T-test and paired T-test were performed to compare the differences between groups. Based on pre and postoperative analysis of POCD patients, the findings revealed 5 differentially expressed genes. The downregulated genes were KIR3DL2, KIR2DS3, and KIR2DS2, which are involved in immunoregulatory responses, and LIM2, a gene involved in cataractogenesis. Whilst the upregulated gene was ERFE, that is involved in iron metabolisms. For postoperative analysis of POCD and non-POCD patients, one gene was downregulated, which is BTNL3, that involved is in immunoregulation. A significantly higher concentration of erythroferrone protein, ERFE, was found in POCD patients’ plasma than in non-POCD patients (p<0.05). Receiver Operating Characteristic (ROC) curve was generated and revealed that ERFE has a moderate performance in predicting POCD with the threshold set at 0.761 with specificity and sensitivity at 80% and 50% (AUC:0.685, 95% CI: 0.564 to 0.802, p<0.05). In conclusion, immunoregulatory and iron metabolism genes are potential genes involved in POCD development. ERFE concentration in plasma may potentially be used as a biomarker for clinicians to predict POCD. This study serves as a pioneer in understanding POCD at the molecular level.
format Thesis
author Noor Anisah Binti Abu Yazit
author_facet Noor Anisah Binti Abu Yazit
author_sort Noor Anisah Binti Abu Yazit
title Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
title_short Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
title_full Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
title_fullStr Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
title_full_unstemmed Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients
title_sort gene expression profiling for postoperative cognitive dysfunction (pocd) among high risk coronary artery bypass graft (cabg) patients
granting_institution Universiti Sains Islam Malaysia
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spelling my-usim-ddms-132522024-05-29T18:36:01Z Gene Expression Profiling for Postoperative Cognitive Dysfunction (POCD) Among High Risk Coronary Artery Bypass Graft (CABG) Patients Noor Anisah Binti Abu Yazit Postoperative cognitive dysfunction (POCD) is the undesirable complication following surgery that significantly impacts patients’ quality of life. The outcome of POCD is characterized by mental disorders, anxiety, personality changes and impaired memory. This study aimed to identify the differentially expressed genes (DEGs) in high-risk CABG patients with POCD and the level of the protein biomarker that correlates with the expressed gene. Forty-six patients scheduled for high-risk CABG procedures were selected based on inclusion and exclusion criteria. Cognitive assessments were done one day before and seven days after surgery to classify POCD. For DEGs analysis using microarray, ribonucleic acid (RNA) samples were collected from patients’ blood one day preoperative and 3 days postoperatively. A total of 16 samples from the 46 patients were selected for microarray analysis. Further, an enzyme-linked immunosorbent assay (ELISA) was conducted to determine the level of protein biomarkers related to the DEGs. Independent T-test and paired T-test were performed to compare the differences between groups. Based on pre and postoperative analysis of POCD patients, the findings revealed 5 differentially expressed genes. The downregulated genes were KIR3DL2, KIR2DS3, and KIR2DS2, which are involved in immunoregulatory responses, and LIM2, a gene involved in cataractogenesis. Whilst the upregulated gene was ERFE, that is involved in iron metabolisms. For postoperative analysis of POCD and non-POCD patients, one gene was downregulated, which is BTNL3, that involved is in immunoregulation. A significantly higher concentration of erythroferrone protein, ERFE, was found in POCD patients’ plasma than in non-POCD patients (p<0.05). Receiver Operating Characteristic (ROC) curve was generated and revealed that ERFE has a moderate performance in predicting POCD with the threshold set at 0.761 with specificity and sensitivity at 80% and 50% (AUC:0.685, 95% CI: 0.564 to 0.802, p<0.05). In conclusion, immunoregulatory and iron metabolism genes are potential genes involved in POCD development. ERFE concentration in plasma may potentially be used as a biomarker for clinicians to predict POCD. This study serves as a pioneer in understanding POCD at the molecular level. 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