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Evaluation of apoptosis in cerebrospinal fluid of patients with severe head injury

  • Clinical Article
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Summary

Objective. To determine whether sFas, caspase-3, proteins which propagate apoptosis, and bcl-2, a protein which inhibits apoptosis, would be increased in cerebrospinal fluid (CSF) in patients with severe traumatic brain injury (TBI) and to examine the correlation of sFas, caspase-3, and bcl-2 with each other and with clinical variables.

Methods. sFas, caspase-3, and bcl-2 were measured in CSF of 14 patients with severe TBI on days 1, 2, 3, 5, 7, and 10 post-trauma. The results were compared with CSF samples from control patients who had no brain and spinal pathology and had undergone spinal anesthesia for some other reason. Soluble Fas and bcl-2 were measured by ELISA while caspase-3 was measured enzymatically.

Results. No sFas, caspase-3, and bcl-2 activities were found in CSF of controls, but activities significantly increased in CSF of patients at all time points post-trauma (p < 0.01). Caspase-3 significantly correlated to intracranial pressure (p = 0.01) and cerebral perfusion pressure (p = 0.04). Soluble Fas and caspase-3 peaks coincided on day 5 post-trauma and there was significant association between sFas and caspase-3 increase (p = 0.01).

Conclusion. This study indicates a prolonged activation of pro-apoptotic (sFas, caspase-3) and anti-apoptotic (bcl-2) proteins after severe TBI in humans. The degree of activation of particularly caspase-3 may be related to the severity of the injury. Parallel increases of these three molecules may indicate a pivotal role of apoptosis in the pathophysiology of post-traumatic brain oedema, secondary cell destruction and chronic cell loss following severe TBI and may open new targets for post-traumatic therapeutic interventions.

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Authors and Affiliations

  1. Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    M. Uzan, H. Erman, T. Tanriverdi, G. Z. Sanus & A. Kafadar

  2. Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    H. Uzun

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  1. M. Uzan
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  2. H. Erman
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Uzan, M., Erman, H., Tanriverdi, T. et al. Evaluation of apoptosis in cerebrospinal fluid of patients with severe head injury. Acta Neurochir (Wien) 148, 1157–1164 (2006). https://doi.org/10.1007/s00701-006-0887-1

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  • DOI: https://doi.org/10.1007/s00701-006-0887-1

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