NAMPT is another indicator for prognosis. It is the rate-limiting component in the mammalian nicotinamide adenine dinucleotide (NAD) biosynthesis pathway, and promotes vascular smooth muscle cell maturation and inhibition of neutrophil Bortezomib LDP-341 apoptosis. It was originally thought to be a cytokine that acted on early B-lineage precursor cells or T cell development, by enhancing the effect of IL-7 and SKP1-CUL1-F-box protein (SCF) on pre-B-cell colony formation. SCF mediates the ubiquitination of proteins involved in cell cycle progression, signal transduction and transcription. PDGFA is also a predictive factor for prognosis. It is activated in IFN-��/IL-10 signaling in keratinocytes via the JAK/STAT pathway and is also involved in signaling via the MAPK cascades, STATs and NF-��B through its receptor.
It contributes to balancing the Th1/Th2 switch by affecting anti-apoptosis and cell proliferation. EGR1 is targeted by Erk, is activated by IL-2 and IL-3 cascades, and targets eukaryotic translation initiation factor 4E binding protein 1. Severe inflammatory disease is a critical condition linked to collapse of the Th1/Th2 balance and, from a prognostic standpoint, these genes are upregulated when Th1 cells (producing IL-2, IL-3 and IFN-��) are dominant over Th2 cells (generating IL-10 and leading to IL-7 activation). This suggests that novel therapeutic antibody drugs for SIRS may be found in the study of these cytokines. TGF-�� mRNA in serum has previously been described as a prognosticator in fulminant hepatitis [11] although this was not the case in our study.
Expression of CRP mRNA correlated with the serum CRP level at all clinical phases, although we could not optimize the reaction condition for detecting CRP mRNA. We reconfirmed that CRP is an excellent marker for acute inflammation, but not for prognosis and SIRS onset. These prognostic genes for SIRS or sepsis may be useful in intensive care settings for earlier detection of decompensation [51]. Conclusion We proposed measuring an inflammatory gene expression profile perioperatively in patients undergoing surgery for esophageal cancer. VWF and TGFB1 mRNA at POD 0 were prognostic biomarkers for mortality. IL-6 mRNA was a significant biomarker for the onset of severe inflammatory conditions and its upregulation throughout the postoperative Carfilzomib period predicted poor prognosis. We could not distinguish SIRS from bacteremia. Further prospective studies on individual gene expression profiles are necessary to clarify their influence on prognosis in esophageal cancer.