{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:05Z","timestamp":1760143205938,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T00:00:00Z","timestamp":1705708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Critical illness-related corticosteroid insufficiency (CIRCI) can cause hemodynamic instability in neonates after congenital heart surgery with manifestations that increase morbidity and potential mortality. We retrospectively reviewed neonates who underwent cardiac surgery between August 2018 and July 2020 at a freestanding children\u2019s hospital, had next-generation sequencing performed, and had their cortisol levels drawn as standard clinical care after cardiac surgery. The groups were defined as CIRCI (with a cortisol level \u2264 4.5 mcg\/dL) and non-CIRCI (level &gt; 4.5 mcg\/dL). The CIRCI group (n = 8) had a 100% incidence of heterozygous gene mutation on STX1A with splicing or loss of function, and this mutation was not found in the non-CIRCI group (n = 8). Additional gene mutations were found in the CIRCI group on RAB6A, ABCA3, SIDT2, and LILRB3, with no incidence in the non-CIRCI group. Three additional mutations were found across the CIRCI group in INPPL1 and FAM189A2 (both splicing and missense), with 12\u201325% of patients in the non-CIRCI group also displaying these mutations. Novel genetic abnormalities were seen in neonates with symptoms of CIRCI with potential cardiac implications from a gene mutation for STX1A. Compounding effects of additional gene mutations need to be confirmed and explored for potential predisposition to hemodynamic instability during times of stress.<\/jats:p>","DOI":"10.3390\/genes15010128","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T03:50:22Z","timestamp":1705895422000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SNARE-ing the Reason for Post-Cardiac Surgery Critical Illness-Related Corticosteroid Insufficiency"],"prefix":"10.3390","volume":"15","author":[{"given":"Nicholas","family":"Diehl","sequence":"first","affiliation":[{"name":"Graduate Medical Education, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Kibiryeva","sequence":"additional","affiliation":[{"name":"Biosciences, Kansas City University, Kansas City, MO 64106, USA"},{"name":"Ward Family Heart Center, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Marshall","sequence":"additional","affiliation":[{"name":"Strategy, Innovation, and Partnerships, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Endocrinology, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"},{"name":"School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9731-2876","authenticated-orcid":false,"given":"Juan S.","family":"Farias","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Silva-Gburek","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA"},{"name":"Department of Critical Care, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0406-6595","authenticated-orcid":false,"given":"Lori A.","family":"Erickson","sequence":"additional","affiliation":[{"name":"Ward Family Heart Center, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"},{"name":"Strategy, Innovation, and Partnerships, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/SHK.0000000000000355","article-title":"A cohort study of pediatric shock: Frequency of corticosteriod use and association with clinical outcomes","volume":"44","author":"Menon","year":"2015","journal-title":"Shock"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/PCC.0b013e3181a64743","article-title":"Adrenocortical response in infants undergoing cardiac surgery with cardiopulmonary bypass and circulatory arrest","volume":"11","author":"Gajarski","year":"2010","journal-title":"Pediatr. 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