title: Heme oxygenase 1 in cerebrospinal fluid from infants and children after severe traumatic brain injury.
abstract: Heme oxygenase 1 (HO-1) is an enzyme important in the catabolism of heme that is induced under conditions of oxidative stress. HO-1 degradation of heme yields biliverdin, bilirubin, carbon monoxide and iron. HO-1 is thought to serve a protective antioxidant function, and upregulation of HO-1 has been demonstrated in experimental models of neurodegeneration, subarachnoid hemorrhage, cerebral ischemia and traumatic brain injury (TBI). We measured HO-1 concentration in cerebral spinal fluid samples from 48 infants and children following TBI and 7 control patients by ELISA. Increased HO-1 was seen in TBI versus control patients--mean 2.75+/-0.63, peak 4.17+/-0.96 ng/ml versus control (<0.078 ng/ml, not detectable) (p<0.001). Increased HO-1 concentration was associated with increased injury severity and unfavorable neurological outcome (both p<0.05). Increased HO-1 concentration was independently associated with younger age; however, statistical analysis could not rule out the possibility that the effect of age was related to inflicted TBI from child abuse. HO-1 increases after TBI and appears to be more prominent in infants compared with older children after injury.
authors.affiliation: Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, and Children's Hospital of Pittsburgh, PA 15213, USA.
authors.forename: J'mir L
authors.initials: JL
authors.lastname: Cousar
authors.forename: Yichen
authors.initials: Y
authors.lastname: Lai
authors.forename: Christina D
authors.initials: CD
authors.lastname: Marco
authors.forename: Hülya
authors.initials: H
authors.lastname: Bayir
authors.forename: P David
authors.initials: PD
authors.lastname: Adelson
authors.forename: Keri L
authors.initials: KL
authors.lastname: Janesko-Feldman
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kochanek
authors.forename: Robert S B
authors.initials: RS
authors.lastname: Clark
mesh_terms: D000367:Age Factors; D000375:Aging / Q000502:physiology; D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D001921:Brain / Q000201:enzymology* / Q000503:physiopathology*; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000201:enzymology*; D002545:Brain Ischemia / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000201:enzymology; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006418:Heme / Q000378:metabolism; D051547:Heme Oxygenase-1 / Q000032:analysis / Q000134:cerebrospinal fluid*; D006801:Humans; D007223:Infant; D008297:Male; D009410:Nerve Degeneration / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000201:enzymology; D018384:Oxidative Stress / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D015854:Up-Regulation / Q000502:physiology
chemical_list: D015415:Biomarkers; D006418:Heme; D051547:Heme Oxygenase-1