Anesth Analg 2006;102:1295-1296
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000199219.08637.76
LETTER TO THE EDITOR
S-100 and NSE Changes After Cardiac Surgery: Evaluation of Multiple Single Nucleotide Polymorphisms
W. Andrew Kofke, MD, MBA, FCCM,
Albert T. Cheung, MD,
John G. Augoustides, MD,
James G. Hecker, PhD, MD, and
Joseph Bavaria, MD
Department of Anesthesiology and Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, kofkea{at}uphs.upenn.edu
To the Editor:
We recently reported a relationship among levels of biochemical markers for brain injury, neuron specific enolase (NSE), and S100ß and the Apo E4 allele (1) after cardiac surgery. Using retained DNA samples from the previously reported work and after approval by the biomedical IRB to examine retained DNA, we tested the hypothesis that NSE and S100ß elevations noted in these same patients would also be related to the presence of other single nucleotide polymorphisms. Briefly, in patients scheduled for cardiac surgery, arterial blood samples were drawn within 1 h before and 8 and 24 h after induction of anesthesia and were later assayed for NSE and S-100ß by radioimmunoassay and assayed for genotypes (from retained DNA), undergoing stepwise linear regression (SPSS 13.0, SPSS, Inc, Chicago, IL). Two stepwise regressions were performed. The first was conservative, with entry P < 0.1 and exclusion P > 0.2 and the second used entry P < 0.2 and exclusion P > 0.4. The polymorphisms evaluated were: apolipoprotein E (ApoE 2, 3, 4) (1,2); methylenetetrahydrofolate reductase (MTHFR(C677T)) (3); angiotensin converting enzyme (ACE I/D) (4); interleukin-6 (IL-6(G174C)) (5); nitric oxide synthase (NOS(G298A)) (6); two heat shock proteins (HSPA1B HSPA1L) (7,8); myeloperoxidase (MPO(G129A)) (9); and endothelin (ET(G8002A)) (10).
The regressions are summarized in Tables 1 and 2, suggesting a significant effect of ApoE4 and HSPA1-G and a trend for MPO-G, NOS-C, and MTHFR-G.
Our limited dataset, using a biochemical indicator of injury in a relatively small and heterogeneous group, provides further support for the notion that patients with not only ApoE4 but also MPO-G and NOS-C alleles may be at increased risk for postoperative neuronal injury, whereas those with the HSPA1-G may be protected.
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