Soluble adhesion molecules in CSF are increased in children with severe head injury.
Leukocyte-endothelial adhesion molecules, critical to the development of acute inflammation, are expressed in brain as part of the acute inflammatory response to traumatic brain injury (TBI). We measured the concentrations of the adhesion molecules P-selectin, ICAM-1, E-selectin, L-selectin, and VCAM-1 in ventricular cerebrospinal fluid (CSF) from children with severe TBI (Glasgow coma score < 8) and compared these findings with those from children with bacterial meningitis. P-selectin, an adhesion molecule associated with ischemia/reperfusion, was increased in children with TBI versus meningitis and control. Univariate and multivariate regression analyses demonstrated associations between CSF P-selectin and child abuse and age of < 4 years, and a significant, independent association between CSF intercellular adhesion molecule-1 (ICAM-1) and child abuse. These results are consistent with a specific acute inflammatory component to TBI in children. Future studies of secondary injury mechanisms and therapy after TBI should assess on the roles of P-selectin and ICAM-1 in injury and repair processes in brain after TBI.
Whalen
M J
MJ
Department of Anesthesiology and Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh, Pennsylvania 15260, USA.
Carlos
T M
TM
Kochanek
P M
PM
Wisniewski
S R
SR
Bell
M J
MJ
Carcillo
J A
JA
Clark
R S
RS
DeKosky
S T
ST
Adelson
P D
PD
D000293:Adolescent; D000704:Analysis of Variance; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000150:complications; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000134:cerebrospinal fluid*; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D018799:Intercellular Adhesion Molecule-1 / Q000134:cerebrospinal fluid; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D019087:Selectins / Q000134:cerebrospinal fluid; D019010:Vascular Cell Adhesion Molecule-1 / Q000134:cerebrospinal fluid
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019087:Selectins; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1