F2-isoprostane and neuron-specific enolase in cerebrospinal fluid after severe traumatic brain injury in infants and children.
It has been hypothesized that oxidative stress plays an important role in mediating secondary damage after traumatic brain injury (TBI). To study the relationship between lipid peroxidation, clinical variables, and neuronal damage in pediatric TBI, we measured levels of F2-isoprostane, a marker of lipid peroxidation, and neuron-specific enolase (NSE), a marker of neuronal damage, in serial cerebrospinal fluid (CSF) samples from 23 infants and children with severe TBI (Glasgow Coma Scale score <8). These were compared to CSF samples from 10 uninjured pediatric controls. On d1 after injury, F2-isoprostane was increased 6-fold vs. control (36.59+/-8.96 pg/ml vs. 5.64+/-8.08 pg/ml, p=0.0035) and NSE was increased 10-fold (100.62+/-17.34 ng/ml vs. 8.63+/-2.76 ng/ml, p=0.0002). Multivariate analysis of F2-isoprostane levels and selected clinical variables showed a trend toward an inverse association with time after injury (p=0.0708). Multivariate analysis of NSE levels and selected variables showed a positive association between d1 NSE and F2-isoprostane (p=0.0426). CSF F2-isoprostane increases early after TBI in infants and children and is correlated with NSE, supporting a role for oxidative stress in the evolution of secondary damage early after severe TBI in infants and children.
Varma
Sumeeta
S
Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15260, USA.
Janesko
Keri L
KL
Wisniewski
Stephen R
SR
Bayir
Hülya
H
Adelson
P David
PD
Thomas
Neal J
NJ
Kochanek
Patrick M
PM
D000293:Adolescent; D001930:Brain Injuries / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D028441:F2-Isoprostanes / Q000134:cerebrospinal fluid*; D005260:Female; D005609:Free Radicals; D006801:Humans; D007223:Infant; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D018384:Oxidative Stress; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid*; D013997:Time Factors
D028441:F2-Isoprostanes; D005609:Free Radicals; D010751:Phosphopyruvate Hydratase