Comparative Proteome Analysis Between The Sera Of Anterior And Posterior Cardiopulmonary Bypass Procedure In Open Heart Surgery Patients

Because of the activation of phlegmasia mediums such as complement, bradykinin, and others,the body will develop to a condition similar to "General Inflammatory Reaction" after cardiopulmonary bypass (CPB) procedures.This will have harmful effects on the vitals such as heart,brain,lung, kidney,etc.and result in severe postoperative complication such as acute respiratory distress syndrome(ARDS), renal inadequacy,arrhythmia,low cardiac output,and so on. The present study screened the differential proteins from anterior and posterior CPB procedure sera of open heart surgery patients,which will help to study the pathophysiology mechanism of pathologic states related to CPB and to approach the prophylaxis and treatment of complications related to CPB.In this study, serum proteomics technique was used to screen the differential proteins from the sera of anterior and posterior CPB procedure in open heart surgery patients. For each patient, blood samples were taken approximately 30 min before initiation of CPB (time point 1), 1 h postweaning from CPB (time point 2), and 24 h postweaning from CPB (time point 3). serum proteins were isolated using two dimensional gel electrophoresis(2-DE). The protein spots were analyzed by the PDQuest image analysis software and the differential protein spots were identified by matrix-assisted laser desorption / ionization - time of flight -mass spectrometry (MALDI-TOF-MS). Then, enzyme linked immunosorbent assay (ELISA) was used to determine the expression level of serum amyloid A protein (SAA) in the serum of healthy people and three different time points (30 min before initiation of CPB,1 h postweaning from CPB,and 24 h postweaning from CPB ) of open heart surgery patients. The prospects of clinical application of SAA were further discussed.Through 2-DE in combination with MALDI-TOF-MS, 3 proteins altered in expression were identified, including Haptoglobin (HPT), Leucine-rich alpha-2-glycoprotein (A2GL),Serum amyloid A protein(SAA). ELISA analysis showed that compared with the time point of 30 min before initiation of CPB, SAA levels rise three times at the time point of 1 h postweaning from CPB and rise nineteen times at the time point of 24 h postweaning from CPB. But levels of SAA in the serum of healthy people have not significant deviation compared with the time point of 30 min before initiation of CPB.The results of this pilot study illustrate HPT, A2GL and SAA may be related with haemolysis, tissue damage, inflammation,and so on during and following CPB procedures. HPT can be used in judging the degree of haemolysis in open heart surgery patients. SAA is an subservient and sensitive biochemical indicator of the acute-phase response following CPB.