Department of Pediatric Surgery Azerbaijan Medical University Baku Azerbaijan

Background Cardiopulmonary bypass (CPB) is necessary for the treatment of many congenital cardiac problems in babies, but it also causes substantial hemostasis and inflammatory system disorders. Therefore, managing children who need CPB or extracorporeal membrane oxygenation presents significant management issues due to hemorrhagic consequences and thrombosis. Traditional clinical laboratory tests can identify specific hemostatic abnormalities (low platelets, elevated fibrinogen), but they are unable to explain the intricate, overlapping relationships between the different aspects of coagulation, such as cellular interactions, contact activation, fibrinolysis, and inflammation. We predicted that an objective proteomic analysis would assist discover networks of interacting proteins for additional research in paediatric cancers given recent developments in analytical techniques for detecting protein-protein interactions in the plasma proteome. Materials and methods Infants up to one year old were admitted. After CPB, plasma samples were taken at 0, 1, 4, and 24 hours. Proteins undergoing changes in concentration following CPB were found using mass spectrometry, and biological networks were found using STRING and ToppGene algorithms. Using two-dimensional difference gel electrophoresis, protein concentration variations were found. At the same time points, inflammatory indicators were evaluated using an enzyme-linked immunosorbent test. Results Ten newborns with cardiac abnormalities needed surgery and CPB; no serious problems were noted (median age, 127.5 d; interquartile range, 181.25 d). More than 1400 individual protein spots were seen using two-dimensional difference gel electrophoresis, and 89 proteins showed a change in concentration of more than 30% with a P value of less than 0.02 when comparing 1, 4, or 24 h. Using mass spectrometry, 29 protein spots (33% of those with significant changes in concentration following CPB) were found. The acute phase response, coagulation, and cell signalling functional categories dominated the results of our investigation into the functional relationships among these differentially expressed proteins. Enzyme-linked immunosorbent assay analysis of cytokines revealed that IL-2, IL-8, and IL-10 were raised at 4 h but returned to baseline by 24 h, whereas IL-6 remained chronically elevated. Conclusions When exposed to CPB, infants display a strong reaction that involves many, interconnected pathways. It may be possible to develop new therapies or biomarkers that are helpful in the care of infants who require CPB with further research into the relationships between immunological, coagulation, and cell signalling systems.

Proteomics, Inflammation, Cardiopulmonary bypass, Pediatrics, Congenital cardiac surgery

Dr.Gasibova JM. Utilizing Modern Ontological Tools, Proteomic Analysis of Infants Undergoing Cardiopulmonary Bypass. Insights Journal of Surgery and Clinical Case Reports 2021.