Association of Indoleamine 2,3-Dioxygenase (IDO) Activity with Outcome after Cardiac Surgery in Adult Patients.

Stieger, Andrea; Huber, Markus; Yu, Zhanru; Kessler, Benedikt M; Fischer, Roman; Andereggen, Lukas; Kobel, Beatrice; Stueber, Frank; Luedi, Markus M; Filipovic, Mark G (2024). Association of Indoleamine 2,3-Dioxygenase (IDO) Activity with Outcome after Cardiac Surgery in Adult Patients. Metabolites, 14(6) MDPI 10.3390/metabo14060334

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Indoleamine 2,3-deoxygenase (IDO) plays an important role in the catabolism of the amino acid tryptophan. Tryptophan and its metabolites are key immune modulators. Increased IDO activity has been observed in various diseases and is associated with worse clinical outcomes. However, comprehensive research regarding its role in cardiac surgery remains limited. Therefore, we aimed to investigate perioperative changes in IDO activity and pathway metabolites, along with their impact on clinical outcomes in adult patients undergoing cardiac surgery. As an observational cohort study conducted at the Inselspital in Bern from January to December 2019, we retrospectively analyzed the data of prospectively collected biobank samples of patients undergoing cardiac surgery with the use of cardiopulmonary bypass. IDO pathway metabolite analysis was conducted by mass spectrometry. Perioperative dynamics were descriptively assessed and associated with pre-defined clinical outcome measures (30-day mortality, 1-year mortality, incidence of stroke and myocardial infarction, and length of hospital stay) through a multi-step exploratory regression analysis. A cohort of 192 adult patients undergoing cardiac surgery with the use of cardiopulmonary bypass were included (median age 67.0, IQR 60.0-73.0, 75.5% male). A significant perioperative decrease in the kynurenine/tryptophan (Kyn/Trp) ratio (-2.298, 95% CI -4.028 to -596, p = 0.009) and significant perioperative dynamics in the associated metabolites was observed. No association of perioperative changes in IDO activity and pathway metabolites with clinical outcomes was found. A significant decrease in the Kyn/Trp ratio among adult patients undergoing cardiac surgery indicates a perioperative downregulation of IDO, which stands in contrast to other pro-inflammatory conditions. Further studies are needed to investigate IDO in the setting of perioperative immunomodulation, which is a key driver of postoperative complications in cardiac surgery patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel

UniBE Contributor:

Huber, Markus, Stüber, Frank, Lüdi, Markus, Filipovic, Mark Georg

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2218-1989

Publisher:

MDPI

Language:

English

Submitter:

Pubmed Import

Date Deposited:

27 Jun 2024 10:47

Last Modified:

27 Jun 2024 10:47

Publisher DOI:

10.3390/metabo14060334

PubMed ID:

38921469

Uncontrolled Keywords:

cardiac surgery cardiopulmonary bypass indoleamine 2,3-dioxygenase outcome tryptophan catabolism

BORIS DOI:

10.48350/198144

URI:

https://boris.unibe.ch/id/eprint/198144

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