Genomic Analysis for Diagnosing Trauma

A recent publication described the first steps being taken to establish a network for the diagnosis of trauma victims through genomic analysis.

"It has been clear for approximately two decades that critical injury can trigger the release of immune factors that cause massive inflammation, and this can sometimes overwhelm the body's ability to cope,” said first author Dr. J. Perren Cobb, associate professor of surgery and of genetics at Washington University School of Medicine (St. Louis, MO; USA). "We have produced a great deal of insight into how those inflammatory responses are generated, and we have tried a number of strategies to block or weaken them, but so far we have had relatively little success.”

A national collaborative effort called the Inflammation and Host Response to Injury Large Scale Collaboration Program, comprising more than 70 physicians and research scientists, was instituted to determine whether commercially available microarray technology could be used to measure changes in gene activity brought about by severe trauma. Blood samples and skeletal muscle from 34 severely injured patients and 23 healthy individuals were analyzed.


Results published in the March 29, 2005, issue of the Proceedings of the [U.S.] National Academy of Sciences showed that blood leukocyte gene expression in the same individual over a 24-hour period was remarkably constant. In contrast, genome-wide expression varied significantly among different subjects and leukocyte subpopulations.
Traumatic injury induced dramatic changes in apparent gene expression that were greater in magnitude than the analytic noise and variance among individuals.

The current study showed that by paying careful attention to analytic details it is possible to reduce the variance in the clinical setting to a level where patterns of gene expression are informative among different healthy human subjects, and can be studied with confidence in human disease.




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Washington University School of Medicine