Abstract
Objective: evaluation of telomere length change in acutely ill adult patients. Design: Blood samples were drawn on the first and seventh day of intensive care unit (ICU) stay to assess telomere length using a polymerase chain reaction (PCR)-based technique. Demographic data collected included age, weight, admission diagnosis, baseline laboratory values (pH, C- reactive protein (CRP), serum albumin level, white blood cell count (WBC) count, platelet count), and baseline SOFA and APACHE II scores. Additional data collected during the ICU stay included a repeated WBC count, the presence of positive blood cultures and outcome data, including death in the ICU or following discharge, whether ventilated or not at ICU discharge, and destination following discharge, i.e., medical ward or rehabilitation. Setting: General ICU in tertiary hospital. Patients: Forty patients admitted to the ICU within 72 h of hospital admission suffering from an acute illness were included in this prospective, observational study. Main results: Of the 40 patients studied, telomere shortening was noted in 21, telomere lengthening in 11, and no significant change in the other eight. The age of patients demonstrating telomere shortening was statistically significantly younger (45.4 vs. 61.5 years, p < 0.023) compared to those showing increased telomere length. In addition, a significant correlation was observed between the difference in telomere length and the corresponding difference in WBC count (telomere shortening was associated with a decreased WBC count and vice versa). A trend toward shortening was seen in patients with sepsis (p = 0.07). No significant correlations were found for any other demographic or outcome parameter and changes in telomere length. Conclusion: Changes in telomere length, both shortening and lengthening, were evident in the acute setting, but no associations between such changes with outcome were noted. Further studies in more homogeneous groups of patients appear to be warranted.
Highlights
Ill patients hospitalized in the intensive care unit (ICU) typically develop an inflammatory, hypermetabolic state defined as the acute phase, which is associated with severe metabolic stress [1].A common example is sepsis, which is defined as life-threatening organ dysfunction due to a dysregulated host response to infection [2], which may result in a complex proinflammatory andGenes 2019, 10, 761; doi:10.3390/genes10100761 www.mdpi.com/journal/genesGenes 2019, 10, 761 coagulant response [3,4,5,6,7]
Count with a Pearson correlation of 0.23 (Figure 2)
We demonstrated that significant changes in telomere length, both increases and decreases, over a short timethat period
Summary
Genes 2019, 10, 761 coagulant response [3,4,5,6,7]. This state, referred to as systemic inflammatory response syndrome (SIRS), is typically associated with the production of various labile reactive species, including gaseous mediators as well as reactive oxygen species, which play a central role in the pathophysiologic events characterizing the inflammatory response. Telomere structures are composed of 1000–2000 repeats of TTAGGG sequences in humans, coated by six-protein complexes called shelterins. These complexes protect telomeres from being recognized by cellular DNA repair mechanisms that otherwise may define them as double-strand
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