System Biology-Based Prognostic Biomarkers of Clinical Complications in Acutely Injured Patients

In the September 13^th issue of PLoS One (link), John D. Storey and colleagues report on inflammation-related gene expression signatures associated with differential clinical outcome in acute trauma patients.  Specifically, the authors analyzed the expression of inflammation-related genes in 168 blunt-force trauma patients over a 28-day period.  The genes and gene pathways that clustered differently between patients’ clinical outcome subgroups (based on Marshall multiple organ failure clinical score) were assembled into predictive modules of clinical outcomes.  Of particularly interest, the down-regulation of MHC II expression within 48 hours of trauma and up-regulation of p38-MAPK within 100 hours of trauma were particularly robust independent predictors of negative clinical outcome in this patient sample.

Considering that up to 60% of late trauma mortality is caused by infections, sepsis, and multiple organ failure multiple organ, the management of these inflammation-related complications remains a major unmet medical need.  In particular, the ability to predict the individual patient clinical trajectory early during trauma treatment remains a significant challenge for the medical community.  Therefore, the prospect of using gene expression as a prognostic biomarker to manage the care of trauma patients is of particular significance.

Thierry Sornasse for Integrated Biomarker Strategy