Erythrocyte indicators of oxidative changes in patients with graded traumatic head injury.
BACKGROUND
Acute oxidative stress following a traumatic head injury (HI) has been implicated in inducing severe secondary brain damage and influencing the clinical outcome of HI patients.


OBJECTIVE
This study was performed to evaluate and compare the oxidative changes in patients with varying severity of HI in the early posttraumatic period using erythrocyte indicators.


METHODS
Head injury patients were divided into two groups based on their Glasgow Coma Scale (GCS) scores recorded at admission to the hospital on the day of trauma itself. Accordingly, the study included 30 severe HI (SHI, GCS scores 8 or less) and 25 Mild HI (MHI, GCS scores more than 8) patients. Thirty age and sex-matched healthy individuals were included in this comparative study as controls.


METHODS
Blood samples were obtained from controls and HI patients (within 24 h of trauma onset). Erythrocyte oxidative changes were studied by estimating thiobarbituric acid reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD) and glutathione reductase (GR).


RESULTS
Erythrocyte TBARS levels were significantly higher and GSH levels were significantly lower in SHI and MHI patients as compared to controls. The SOD activity was significantly increased only in SHI patients and remained unchanged in MHI patients as compared to controls. As compared to MHI patients, erythrocyte TBARS levels were significantly higher, GSH levels were significantly lower and SOD activity was markedly elevated in SHI patients. Erythrocyte GR activity did not show significant changes in both groups of patients as compared to controls.


CONCLUSIONS
Oxidative stress is evident in both SHI and MHI patients in the early posttraumatic period as reflected by their erythrocyte indicators, but the severity of oxidative stress has varied relatively with the severity of head injury. The present findings provide indications that early oxidative changes could influence the neurological recovery of HI patients.
Nayak
Chandrika D
CD
Department of Biochemistry, Melaka Manipal Medical College, (Manipal Campus), and Kasturba Hospital, Manipal, India. chandrikadinesh@yahoo.com
Nayak
Dinesh M
DM
Raja
Annaswamy
A
Rao
Anjali
A
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000097:blood* / Q000145:classification / Q000503:physiopathology*; D004909:Erythrocyte Indices; D005260:Female; D015600:Glasgow Coma Scale; D005978:Glutathione / Q000097:blood; D005980:Glutathione Reductase / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D013482:Superoxide Dismutase / Q000097:blood; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D055815:Young Adult
D017392:Thiobarbituric Acid Reactive Substances; D013482:Superoxide Dismutase; D005980:Glutathione Reductase; D005978:Glutathione