Identification of novel substances related to cardiac arrest and post-cardiac arrest syndrome through comprehensive proteomic analysis

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K16584
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Chiba University
• Principal Investigator: Imaeda Taro 千葉大学, 医学部附属病院, 助教 (30598230)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 心停止後 / 心停止後症候群 / 神経学的予後予測

Outline of Final Research Achievements

To discover biomarkers that can predict neurological prognosis after cardiac arrest at an earlier stage and with higher accuracy, we conducted a study of post-cardiac arrest patients aged 20 years or older who entered the intensive care unit. We performed a comprehensive protein analysis using mass spectrometry on plasma samples within one hour after resuscitation from patients with good neurological prognosis (CPC 1-2) and those with poor prognosis (CPC 3-5). Serpin B1 (Leukocyte elastase inhibitor) and Fatty acid-binding protein 2 (I-FABP) were found only in the poor prognosis group.
These proteins were validated using clinical specimens. The results of ELISA analysis between the good neurological prognosis group (n=27) and the poor prognosis group (n=31) showed that both proteins were significantly higher in the poor prognosis group than in the good neurological prognosis group, with a statistically significant difference between the two groups.

Free Research Field

救急集中治療医学

Academic Significance and Societal Importance of the Research Achievements

近年, 心停止患者に対する人工心肺補助装置を用いた蘇生術や脳低温療法を含む包括的な集中治療が，心停止患者の転帰改善に寄与しているとして注目されている．費用対効果や倫理的側面を考慮し，これらの高価な治療の適応を的確に判断する早期の神経学的予後予測の重要性が高まっている.
今回, 高性能プロテオーム解析機器を用いて，心停止後患者の神経学的予後をより早期に高い精度で予測可能なバイオマーカーになり得るタンパク質を明らかにした. また, これらタンパク質が心停止後の神経学的予後に大きく関与する全身の臓器の虚血/再灌流障害により引き起こされる心停止後症候群の病態解明にもつながるものと考えている.