vCSF Danger-associated Molecular Patterns After Traumatic and Nontraumatic Acute Brain Injury: A Prospective Study.


Journal

Journal of neurosurgical anesthesiology
ISSN: 1537-1921
Titre abrégé: J Neurosurg Anesthesiol
Pays: United States
ID NLM: 8910749

Informations de publication

Date de publication:
27 Apr 2023
Historique:
received: 15 10 2022
accepted: 14 03 2023
medline: 16 5 2023
pubmed: 16 5 2023
entrez: 15 5 2023
Statut: aheadofprint

Résumé

Danger-associated molecular patterns (DAMPs) may be implicated in the pathophysiological pathways associated with an unfavorable outcome after acute brain injury (ABI). We collected samples of ventricular cerebrospinal fluid (vCSF) for 5 days in 50 consecutive patients at risk of intracranial hypertension after traumatic and nontraumatic ABI. Differences in vCSF protein expression over time were evaluated using linear models and selected for functional network analysis using the PANTHER and STRING databases. The primary exposure of interest was the type of brain injury (traumatic vs. nontraumatic), and the primary outcome was the vCSF expression of DAMPs. Secondary exposures of interest included the occurrence of intracranial pressure ≥20 or ≥ 30 mm Hg during the 5 days post-ABI, intensive care unit (ICU) mortality, and neurological outcome (assessed using the Glasgow Outcome Score) at 3 months post-ICU discharge. Secondary outcomes included associations of these exposures with the vCSF expression of DAMPs. A network of 6 DAMPs (DAMP_trauma; protein-protein interaction [PPI] P=0.04) was differentially expressed in patients with ABI of traumatic origin compared with those with nontraumatic ABI. ABI patients with intracranial pressure ≥30 mm Hg differentially expressed a set of 38 DAMPS (DAMP_ICP30; PPI P< 0.001). Proteins in DAMP_ICP30 are involved in cellular proteolysis, complement pathway activation, and post-translational modifications. There were no relationships between DAMP expression and ICU mortality or unfavorable versus favorable outcomes. Specific patterns of vCSF DAMP expression differentiated between traumatic and nontraumatic types of ABI and were associated with increased episodes of severe intracranial hypertension.

Sections du résumé

BACKGROUND BACKGROUND
Danger-associated molecular patterns (DAMPs) may be implicated in the pathophysiological pathways associated with an unfavorable outcome after acute brain injury (ABI).
METHODS METHODS
We collected samples of ventricular cerebrospinal fluid (vCSF) for 5 days in 50 consecutive patients at risk of intracranial hypertension after traumatic and nontraumatic ABI. Differences in vCSF protein expression over time were evaluated using linear models and selected for functional network analysis using the PANTHER and STRING databases. The primary exposure of interest was the type of brain injury (traumatic vs. nontraumatic), and the primary outcome was the vCSF expression of DAMPs. Secondary exposures of interest included the occurrence of intracranial pressure ≥20 or ≥ 30 mm Hg during the 5 days post-ABI, intensive care unit (ICU) mortality, and neurological outcome (assessed using the Glasgow Outcome Score) at 3 months post-ICU discharge. Secondary outcomes included associations of these exposures with the vCSF expression of DAMPs.
RESULTS RESULTS
A network of 6 DAMPs (DAMP_trauma; protein-protein interaction [PPI] P=0.04) was differentially expressed in patients with ABI of traumatic origin compared with those with nontraumatic ABI. ABI patients with intracranial pressure ≥30 mm Hg differentially expressed a set of 38 DAMPS (DAMP_ICP30; PPI P< 0.001). Proteins in DAMP_ICP30 are involved in cellular proteolysis, complement pathway activation, and post-translational modifications. There were no relationships between DAMP expression and ICU mortality or unfavorable versus favorable outcomes.
CONCLUSIONS CONCLUSIONS
Specific patterns of vCSF DAMP expression differentiated between traumatic and nontraumatic types of ABI and were associated with increased episodes of severe intracranial hypertension.

Identifiants

pubmed: 37188652
doi: 10.1097/ANA.0000000000000916
pii: 00008506-990000000-00060
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

D.C. is a Senior Research Associate at the FRS-FNRS. The remaining authors have no conflicts of interest to disclose.

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Auteurs

Carlos A Santacruz (CA)

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Department of Intensive and Critical Care Medicine, Santa Fe de Bogotá Foundation.

Jean-Louis Vincent (JL)

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Jorge Duitama (J)

Systems and Computing Engineering Department, University of los Andes, Bogotá, Colombia.

Edwin Bautista (E)

Department of Intensive and Critical Care Medicine, Santa Fe de Bogotá Foundation.

Virginie Imbault (V)

Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium.

Michael Bruneau (M)

Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Jacques Creteur (J)

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Serge Brimioulle (S)

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

David Communi (D)

Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium.

Fabio S Taccone (FS)

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Classifications MeSH