School of Nursing and Health Studies, 5452University of Miami, Coral Gables, FL, USA.
Dr. Kiran C. Patel College of Osteopathic Medicine, 2814Nova Southeastern University, Fort Lauderdale, FL, USA.
Biol Res Nurs. 2023 Apr;25(2):282-288. doi: 10.1177/10998004221133395. Epub 2022 Oct 10.
Telomeres are structures at the end of chromosomes that shorten with each cell division. The purpose of this pilot project is to report changes in telomere length (T/S ratio), indicators of oxidative stress (serum protein carbonyl, vitamin C, GSH:GSSG, and total antioxidant capacity) from Intensive Care Unit (ICU) admission to ICU discharge, and to explore their association with ICU-related morbidities among critically ill mechanically ventilated adults.
Blood was collected from mechanically ventilated patients ( = 25) at enrollment and within 48 hours of ICU discharge. Telomere length from peripheral blood mononuclear cells (PBMCs) was determined using RTqPCR. ELISAs were used to measure indicators of oxidative stress. Descriptive analysis, paired t-tests, and Pearson's correlations were performed.
Mean age was 62.0 ± 12.3 years, 28.6% were male, and 76.2% were White with disease severity using APACHE III (74.6 ± 24.6) and SOFA (7.6 ± 3.2). Mean T/S ratios shortened (ICU: 0.712, post-ICU: 0.683, < 0.001, = 19) and serum protein carbonyl increased (ICU: 7437 nmol/mg ± 3328, post-ICU: 10,254 nmol/mg ± 3962, < 0.005) as did the oxidative stress index (protein carbonyl/GSH:GSSG, ICU: 1049.972 ± 420.923, post-ICU: 1348.971 ± 417.175, = 0.0104). T/S ratio was positively associated with APACHE III scores (ICU: = 0.474, post-ICU: = 0.628, < 0.05).
Pilot findings suggest that critical illness significantly correlates with telomere attrition, perhaps due to increased oxidative stress. Future larger and longitudinal studies investigating mechanisms of telomere attrition and associations with clinical outcomes are needed to identify potential modifiable factors for subsequent intervention to improve outcomes for critically ill patients.
端粒是染色体末端的结构，随着每次细胞分裂而缩短。本试点项目的目的是报告重症监护病房（ICU）入院至 ICU 出院期间端粒长度（T/S 比值）、氧化应激指标（血清蛋白羰基、维生素 C、GSH:GSSG 和总抗氧化能力）的变化，并探讨其与重症机械通气患者 ICU 相关发病率的关系。
在入组时和 ICU 出院后 48 小时内，从机械通气患者（n=25）中采集血液。使用 RTqPCR 测定外周血单核细胞（PBMC）中的端粒长度。使用 ELISA 测量氧化应激指标。进行描述性分析、配对 t 检验和 Pearson 相关性分析。
平均年龄为 62.0±12.3 岁，28.6%为男性，76.2%为白人，使用 APACHE III（74.6±24.6）和 SOFA（7.6±3.2）评估疾病严重程度。T/S 比值缩短（ICU：0.712，post-ICU：0.683，<0.001，n=19），血清蛋白羰基增加（ICU：7437 nmol/mg±3328，post-ICU：10254 nmol/mg±3962，<0.005），氧化应激指数（蛋白羰基/GSH:GSSG，ICU：1049.972±420.923，post-ICU：1348.971±417.175，n=0.0104）也增加。T/S 比值与 APACHE III 评分呈正相关（ICU：r=0.474，post-ICU：r=0.628，<0.05）。
初步研究结果表明，危重病与端粒损耗显著相关，这可能是由于氧化应激增加所致。未来需要进行更大规模和纵向研究，以探讨端粒损耗的机制及其与临床结果的关系，从而确定潜在的可调节因素，以便随后进行干预，改善危重病患者的预后。
