Exhaled volatile organic compounds, phospho-tau and postoperative delirium

呼出的挥发性有机化合物、磷酸tau和术后谵妄

• 批准号: 10732133
• 负责人: Patrick Finan
• 金额: $ 44.41万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10732133
• 关键词: Acceleration; Address; Aging; Alzheimer' s Disease; Alzheimer' s disease brain; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Amyloid beta-Protein; Amyloid beta-Protein Precursor; Anesthesia procedures; Beds; Biological Markers; Blood; Brain; Brain Injuries; Chemicals; Clinical; Cognitive; Complex; Complication; Delirium; Dementia; Detection; Devices; Diagnosis; Disease; Early Diagnosis; Elderly; Enzyme-Linked Immunosorbent Assay; Equipment; Excision; Exhalation; Functional disorder; Gas Chromatography; Gases; Harvest; Hospitalization; Impaired cognition; Incidence; Individual; Intervention; Life; Light; Measures; Metabolic; Metabolic Pathway; Metabolic dysfunction; Methods; Minor; Modeling; Monitor; Morbidity - disease rate; Neurodegenerative Disorders; Neurofibrillary Tangles; Neurons; Operative Surgical Procedures; Outcome; Pathologic; Patient-Focused Outcomes; Patients; Pattern; Perioperative; Phase; Play; Postoperative Period; Precision therapeutics; Predictive Value; Process; Proteins; Research; Risk; Risk Factors; Role; Senile Plaques; Sensory; Severities; Site; Spine surgery; Stratification; Syndrome; Testing; Time; amyloid peptide; confusion assessment method; data analysis pipeline; denoising; drug development; extracellular; feature extraction; high risk; human old age (65+); hyperphosphorylated tau; improved; improved outcome; mortality; neurofilament; neuroinflammation; neuropathology; neurotoxicity; older patient; patient screening; point of care; portability; postoperative delirium; rapid detection; real time monitoring; recruit; tau Proteins; tau-1; tool; volatile organic compound

Postoperative delirium (POD) is common, especially in elderly patients. Patients with Alzheimer’s disease (AD) or AD-related dementias (ADRD) have a higher risk of delirium. Patients with delirium have a higher chance to develop AD and ADRD. It has been shown that AD-related biomarkers, such as phospho-tau and neurofilament light, in the blood are associated with POD. However, these tests take time and are expensive to perform. Harvesting blood carries a minor risk. Patients with AD and POD have metabolic dysfunction. Studies have shown that there are differences in the volatile organic compounds (VOCs) in the exhaled gases between AD patients and healthy controls. Whether this situation exists between patients with POD and non-POD is not known. Evaluating exhaled VOCs is no-invasive and can be done at bed site with our equipment. We hypothesize that patients with POD have a unique pattern of exhaled VOCs and that this pattern is associated with AD-related biomarkers in the blood. To address these hypotheses, we will recruit 150 patients with spine surgery who are 65 years or older. Their exhaled gases will be analyzed by using advanced portable gas chromatography. Their blood will be used to analyze tau, phospho-tau, neurofilament light and amyloid beta peptides. The POD incidence and severity will be assessed. The VOC and blood biomarker results of patients with POD will be compared with those of patients without POD. The predicting values of VOCs and AD-related biomarkers for POD will be determined. These studies will for the first time determine whether a no-invasive and quick analysis of exhaled VOCs can be used to predict POD. The identified VOCs that contribute to the different patterns between patients with and without POD will indicate metabolic pathways that are dysfunctional. The analysis of the correlation between exhaled VOCs and AD-related biomarkers in the blood may reveal possible relationship between AD-like neuropathology and exhaled VOCs. Thus, this project may provide initial evidence for the role of VOCs in POD and AD-related neuropathology.

术后del妄（POD）很常见，尤其是在老患者中。阿尔茨海默氏症患者 疾病（AD）或与AD相关的痴呆症（ADRD）的ir妄风险更高。 del妄的患者 有更高的机会开发AD和ADRD。已经显示出与广告相关的生物标志物，这样 作为磷酸tau和神经丝的光，血液中的豆荚与豆荚有关。但是，这些测试 花时间，表现昂贵。收获血会带来较小的风险。 AD患者和 POD具有代谢功能障碍。研究表明，挥发性有机物存在差异 AD患者和健康对照组之间耗尽的气体中的化合物（VOC）。是否这样 尚不清楚POD和非POD患者之间存在情况。评估呼出的VOC是 没有侵入性，可以在我们的设备上在床地进行。我们假设POD患者 具有独特的呼出VOC模式，并且这种模式与广告相关的生物标志物有关 在血液中。为了解决这些假设，我们将招募150例脊柱手术患者65例 年以上。他们耗尽的气体将通过使用高级便携式气体分析 色谱法。他们的血液将用于分析tau，磷酸tau，神经丝光和 淀粉样βbeta petides。 POD事件和严重性将被评估。 VOC和血液 将POD患者的生物标志物与无POD的患者进行比较。这 将确定POD的VOC和与AD相关的生物标志物的值。这些研究会 首次确定是否可以使用无创和快速分析呼出的VOC 预测POD。确定的VOC有助于患者和患者之间的不同模式 没有POD将指示功能失调的代谢途径。相关分析 血液中暴露的VOC和与广告相关的生物标志物之间可能揭示可能的关系 在类似广告的神经病理学和呼出的VOC之间。那是这个项目可以提供初始证据 对于VOC在POD和广告相关的神经病理学中的作用。