Serum Biomarkers of a Pro-Neuroinflammatory State May Define the Pre-Operative Risk for Postoperative Delirium in Spine Surgery

作者：Johanna Ruhnau, Jonas Müller, Stephan Nowak, Sarah Strack, Denise Sperlich, ARNOLD W. POHL, Jasmin Dilz, Angelika Saar, Yannick Veser, Frederik Behr, Sebastian Willy Rehberg, Taras Ivanovich Usichenko, Klaus Hahnenkamp, Johannes Ehler, Agnes Flöel, Henry W. S. Schroeder, Jan‐Uwe Müller, Robert D Fleischmann, Antje Vogelgesang · 发表于：International Journal of Molecular Sciences · 年份：2023 · DOI：10.3390/ijms241210335 · 被引用次数：34 · 研究领域：Intensive Care Unit Cognitive Disorders、Anesthesia and Neurotoxicity Research、Intraoperative Neuromonitoring and Anesthetic Effects

Advances in spine surgery enable technically safe interventions in older patients with disabling spine disease, yet postoperative delirium (POD) poses a serious risk for postoperative recovery. This study investigates biomarkers of pro-neuroinflammatory states that may help objectively define the pre-operative risk for POD. This study enrolled patients aged ≥60 scheduled for elective spine surgery under general anesthesia. Biomarkers for a pro-neuroinflammatory state included S100 calcium-binding protein β (S100β), brain-derived neurotrophic factor (BDNF), Gasdermin D, and the soluble ectodomain of the triggering receptor expressed on myeloid cells 2 (sTREM2). Postoperative changes of Interleukin-6 (IL-6), Interleukin-1β (IL-1β), and C-reactive protein (CRP) were assessed as markers of systemic inflammation preoperatively, intraoperatively, and early postoperatively (up to 48 h). Patients with POD (n = 19, 75.7 ± 5.8 years) had higher pre-operative levels of sTREM2 (128.2 ± 69.4 pg/mL vs. 97.2 ± 52.0 pg/mL, p = 0.049) and Gasdermin D (2.9 ± 1.6 pg/mL vs. 2.1 ± 1.4 pg/mL, p = 0.29) than those without POD (n = 25, 75.6 ± 5.1 years). STREM2 was additionally a predictor for POD (OR = 1.01/(pg/mL) [1.00–1.03], p = 0.05), moderated by IL-6 (Wald-χ2 = 4.06, p = 0.04). Patients with POD additionally showed a significant increase in IL-6, IL-1β, and S100β levels on the first postoperative day. This study identified higher levels of sTREM2 and Gasdermin D as potential markers of a pro-...