Study of biomarkers on postoperative delirium and dysfunction of blood-brain barrier

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K22944
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0905:Surgery of the organs maintaining homeostasis and related fields
• Research Institution: The University of Tokyo
• Principal Investigator: Mietani Kazuhito 東京大学, 医学部附属病院, 助教 (90882605)
• Project Period (FY): 2020-09-11 – 2022-03-31
• Keywords: 術後せん妄 / リン酸化ニューロフィラメント重鎖(pNF-H) / 血液脳関門(BBB) / 接着因子 / バイオマーカー

Outline of Final Research Achievements

An objective diagnosis and evaluation method for postoperative delirium has not been established, and the pathogenic mechanism is unknown. In this study, we investigated the presence or absence of delirium in patients undergoing esophageal cancer surgery, and measured and compared various biomarkers together with pNF-H. It was suggested that serum pNF-H levels may be a marker of postoperative delirium in the acute perioperative phase regardless of timing. PAI-1 also increased sharply to 1 POD in postoperative delirium patients, and an increase in PAI-1 from 0 POD to 1 POD was associated with postoperative delirium. This suggests that the combination of highly sensitive PAI-1 and pNF-H may improve the accuracy of early diagnosis of delirium.

Free Research Field

術後せん妄

Academic Significance and Societal Importance of the Research Achievements

今回我々はせん妄発症の有無を調査し、様々なバイオマーカーを測定、比較を行い、血清pNF-H値が周術期急性期においてタイミングに関係なく術後せん妄のマーカーとなる可能性があることを証明した。またPAI-1は、術後せん妄患者の1PODに急激に増加し、0PODから1PODにおけるPAI-1の上昇は術後せん妄と関連していた。このことから感度が高いPAI-1とpNF-Hを組み合わせることで、せん妄の早期診断の精度を高めることができる可能性が示唆された。これにより主観的ではなく客観的なせん妄の診断が可能となり、病態解明及び発症後の治療法開発のための分子マーカーの検索に繋がる可能性が示唆された。