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Correlation between neurotrophic factor expression and outcome of children with severe traumatic brain injury

  • Neonatal and Pediatric Intensive Care
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Abstract

Objectives

We evaluated the neurotrophic factors [nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glia-derived neurotrophic factor (GDNF)] expression and their association with the severity and outcome of children with traumatic brain injury.

Design

Prospective observational clinical study.

Setting

Pediatric intensive care unit.

Patients

Fourteen children with severe head injury; 12 controls with obstructive hydrocephalus.

Measurement

Cerebrospinal fluid (CSF) and plasma samples were collected 2 h (T1) and 24 h (T2) after head injury. Neurotrophic factor levels were measured using an immuno-enzymatic assay.

Main results

In patients, neurotrophic factor mean levels were significantly different in both CSF and plasma, showing high levels of BDNF compared to NGF and GDNF. Considering T1 and T2 expression, in the CSF the level of NGF increased from 3.5±0.4 pg/ml to 48.2±11.7 pg/ml (p<0.001); BDNF decreased from 4854.0±1303.7 pg/ml to 593.0±114.8 pg/ml (p<0.001), while GDNF did not undergo significant variations. In plasma, no significant changes were observed. Regarding severity and outcome, BDNF levels showed a sharp peak after head injury, but the only significant association was between NGF expression in the CSF and a good outcome versus a poor outcome (p=0.007).

Conclusions

The variations in neurotrophic factor levels reflect an endogenous attempt at neuroprotection against biochemical and molecular changes after traumatic head injury. BDNF represents an early marker of brain injury, while NGF expression in the CSF was indicative of a good outcome and the role of this neurotrophin in the treatment of children with severe head injury may be hypothesized.

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Acknowledgements

This work was supported in part by the "Fondazione CARISBO", Bologna (Italy), and by the Project: "Danno cerebrale ipossico/ischemico", Istituto Superiore di Sanità, Italy (funds provided to L. Aloe). The authors thank Prof. Nicholas P. Brennan for the manuscript's revision.

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Catholic University Medical School, Policlinico Gemelli , Largo Gemelli, 1–00168 , Rome, Italy

    Antonio Chiaretti, Marco Piastra, Giancarlo Polidori & Elena Caresta

  2. Pediatric Neurosurgery, Catholic University Medical School, Policlinico Gemelli, Largo Gemelli, 1–00168 , Rome, Italy

    Concezio Di Rocco

  3. Institute of Neurobiology, CNR, Viale Marx 15, 43-00137 , Rome, Italy

    Alessia Antonelli, Tiziana Amendola & Luigi Aloe

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  1. Antonio Chiaretti
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Correspondence to Antonio Chiaretti.

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Chiaretti, A., Piastra, M., Polidori, G. et al. Correlation between neurotrophic factor expression and outcome of children with severe traumatic brain injury. Intensive Care Med 29, 1329–1338 (2003). https://doi.org/10.1007/s00134-003-1852-6

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  • DOI: https://doi.org/10.1007/s00134-003-1852-6

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