Unveiling the Immune Landscape of Delirium through Single‐Cell RNA Sequencing and Machine Learning: Towards Precision Diagnosis and Therapy

Psychogeriatrics, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 1, 2025

Abstract Background Postoperative delirium (POD) poses significant clinical challenges regarding its diagnosis and treatment. Identifying biomarkers that can predict diagnose POD is crucial for improving patient outcomes. Methods To explore potential POD, we conducted bulk RNA sequencing (bulk‐seq) on peripheral blood samples from patients healthy controls. The expression levels of genes downstream the phosphatidylinositol 3‐kinase/protein kinase B (PI3K‐Akt) signalling pathway were analysed. We then validated these using quantitative real‐time polymerase chain reaction (RT‐qPCR) in an independent cohort 30 controls patients. Receiver operating characteristic (ROC) analysis six machine learning models used to evaluate predictive diagnostic value genes. Additionally, single‐cell (scRNA‐seq) was performed validate gene specific subsets mononuclear cells (PBMCs), including T‐cells, B‐cells, natural killer (NK) cells, dendritic (DCs), monocytes. Results Bulk‐seq revealed increased PI3K‐Akt pathway, specifically CHRM2 , IL6 NOS3 NGF IL6R compared Conversely, IGF1 significantly decreased. RT‐qPCR validation confirmed findings. ROC indicated are useful predicting diagnosing POD. scRNA‐seq further PBMC subsets, NK DCs, monocytes, with results consistent bulk‐seq data. Conclusions abnormal activation monocytes may serve as These findings could inform development novel therapeutic strategies managing

Language: Английский

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Intravenous dexmedetomidine for delirium prevention in elderly patients following orthopedic surgery: a meta-analysis of randomized controlled trials

BMC Pharmacology and Toxicology, Journal Year: 2025, Volume and Issue: 26(1)

Published: Jan. 17, 2025

We conducted a meta-analysis to investigate the effect of dexmedetomidine on postoperative delirium in elderly orthopedic surgery patients. A was identify randomized controlled trials patients undergoing surgery. The data published October 25, 2024. PubMed, Embase, and Cochrane Library databases were searched. Outcome measures included incidence delirium, length hospital stay, visual analogue scale, complications. Estimates are expressed as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI). publications reviewed according guidelines Handbook Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA). This study registered INPLASY (number INPLASY2024110004). total 3159 9 trials. results showed that exhibited preventive compared control group after (RR: 0.55, CI: 0.45–0.66, P < 0.01, I2 = 0%). Subgroup analysis suggested significantly different from saline(RR: 0.56; 0.44–0.73, P<0.01, I²=31%) propofol(RR: 0.52; 0.39–0.70, I²=0%) reducing fracture No statistically significant differences observed complications (P > 0.05). Certainty evidence moderate. Dexmedetomidine has been shown have protective following

Language: Английский

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The Role of Cytokines in Perioperative Neurocognitive Disorders: A Review in the Context of Anesthetic Care

Biomedicines, Journal Year: 2025, Volume and Issue: 13(2), P. 506 - 506

Published: Feb. 18, 2025

Perioperative neurocognitive disorders (PNDs), including postoperative delirium, delayed recovery, and long-term disorders, present significant challenges for older patients undergoing surgery. Inflammation is a protective mechanism triggered in response to external pathogens or cellular damage. Historically, the central nervous system (CNS) was considered immunoprivileged due presence of blood-brain barrier (BBB), which serves as physical preventing systemic inflammatory changes from influencing CNS. However, aseptic surgical trauma now recognized induce localized inflammation at site, further exacerbated by release peripheral pro-inflammatory cytokines, can compromise BBB integrity. This breakdown facilitates activation microglia, initiating cascade neuroinflammatory responses that may contribute onset PNDs. review explores mechanisms underlying neuroinflammation, with particular focus on pivotal role cytokines pathogenesis

Language: Английский

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Effect of Continuous Intraoperative Dexmedetomidine on Interleukin-6 and Other Inflammatory Markers After Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

Medicina, Journal Year: 2025, Volume and Issue: 61(5), P. 787 - 787

Published: April 24, 2025

Background and Objectives: Coronary artery bypass graft (CABG) surgery is the most common cardiac surgery. One of main causes postoperative complications increased mortality after CABG inflammatory response. The aim this study was to investigate whether continuous intraoperative dexmedetomidine can reduce increase IL-6 other markers Materials Methods: registered with ClinicalTrials.gov, NCT06378827, accessed on 23 April 2024. This prospective experimental conducted from December 2024 included 100 patients undergoing Patients in group (50 patients) received a infusion (0.5 μg/kg/h) anesthesia induction until end surgery, while control same volume saline. primary outcomes were changes values interleukin-6 (IL-6), C-reactive protein (CRP), white blood cells (WBC), fibrinogen first day (POD1) compared basal, preoperative values. Results: average 65.26 years old, 66.28 old (p = 0.555). From group, 40 (80%) male 37 (74%) 0.635). Median before 2.0 pg/mL, POD 1 it 76.2 pg/mL < 0.001). CRP 2.5 mg/dL, POD1 value 45.5 mg/dL WBC 6.7 × 109/L 13.6 3.19 g/L 3.37 0.024). (ΔIL-6) 72.4 73.0 0.427). ΔCRP 41.2 mg/mL (control group) 38.0 (experimental 0.725). ΔWBC 7.45 6.81 0.407). Δfibrinogen 0.16 0.2 0.771). Conclusions: Intraoperative administration dexmedetodine during at dose 0.5 µg/kg/h without loading does not lead decrease intensity response

Language: Английский

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Clinical effect of using a lower limb warming blanket combined with dexmedetomidine to prevent postoperative delirium and shivering in elderly patients undergoing spinal surgery

Expert Review of Medical Devices, Journal Year: 2025, Volume and Issue: unknown

Published: April 26, 2025

To observe the clinical effect of using a lower limb warming blanket combined with dexmedetomidine (DEX) to prevent postoperative delirium (POD) and shivering in elderly patients undergoing spinal surgery. A total 160 posterior surgery under general anaesthesia were selected divided into control group (group N), heating T), DEX D) TD), 40 each group. The intraoperative dosage, changes body temperature heart rate at different time points (T1-T6) compared, as well occurrence POD groups. During entire procedure, dosage was groups D TD than N T (p < 0.05). exhibited downwards trend, which decreased significantly T2. At T2-T4, that Using can effectively reduce incidence

Language: Английский

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Study on the mechanism of Dexmedetomidine’s effect on postoperative cognitive dysfunction in elderly people

Frontiers in Physiology, Journal Year: 2025, Volume and Issue: 16

Published: March 12, 2025

Postoperative cognitive dysfunction (POCD) is a common complication among elderly patients following surgical procedures, significantly impairing postoperative recovery and quality of life. The selection dosage intraoperative anaesthetic drugs are frequently implicated as contributing factors in the development POCD. In recent years, dexmedetomidine (DEX), novel α2-adrenoceptor agonist, has been increasingly utilized anaesthesia for patients, showing potential both preventive therapeutic agent This paper provides comprehensive review current research on mechanisms by which DEX affects POCD elderly. Additionally, it explores DEX’s action context neuroprotection, anti-inflammation, antioxidative stress, regulation apoptosis, autophagy, analgesia. objective to provide reliable theoretical support reference point clinical application elderly, thereby promoting its broader use practice improve outcomes enhance

Language: Английский

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Has the Use of Minocycline Decreased Delirium Incidence?

CHEST Journal, Journal Year: 2024, Volume and Issue: 166(6), P. e203 - e204

Published: Dec. 1, 2024

Language: Английский

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