Moderate and severe traumatic brain injury induce early overexpression of systemic and brain gelatinases.
OBJECTIVE
Recent experimental evidence suggests that matrix metalloproteinases (MMPs) are implicated in the pathophysiology of traumatic brain injury (TBI) by increasing blood-brain barrier permeability and exacerbating posttraumatic edema. We examined the acute profile of MMP-2 and MMP-9 in the plasma of patients with moderate or severe TBI and in the brain extracellular fluid (ECF).


METHODS
Prospective observational study.


METHODS
Neurotraumatology intensive care unit of a tertiary university hospital.


METHODS
Twenty patients with moderate or severe TBI were included and three groups were used as controls: 20 patients with a mild head injury and normal CT scan, 15 moderate polytrauma patients without TBI, and 20 healthy volunteers.


METHODS
Plasma samples were collected within the first 12[Symbol: see text]h and at 24[Symbol: see text]h post-injury. Simultaneous brain microdialysate and plasma samples were obtained in four moderate-severe TBI patients at additional timepoints: 48, 72, and 96[Symbol: see text]h post-TBI.


RESULTS
Gelatinases (MMP-2 and MMP-9) were measured by gelatin zymography. A significant increase in plasma gelatinases was observed at baseline when compared with healthy volunteers in the study group. This early increase was followed by a significant decrease at 24[Symbol: see text]h post-injury. Brain microdialysis samples presented a similar time profile as plasma samples for both gelatinases.


CONCLUSIONS
High levels of gelatinases were found in plasma and brain ECF in the early phase of TBI, indicating that both local and systemic trauma-induced upregulation of gelatinases in the acute phase might play an important role in the pathophysiology of TBI and could be a future therapeutic target.
Vilalta
Anna
A
Neurotraumatology and Neurosurgery Research Unit , Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona , Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Sahuquillo
Juan
J
Rosell
Anna
A
Poca
Maria A
MA
Riveiro
Marilyn
M
Montaner
Joan
J
D000328:Adult; D001812:Blood-Brain Barrier; D001930:Brain Injuries / Q000145:classification / Q000378:metabolism* / Q000503:physiopathology; D045604:Extracellular Fluid / Q000378:metabolism*; D005260:Female; D018093:Gelatinases / Q000378:metabolism*; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D017551:Microdialysis / Q000379:methods; D011446:Prospective Studies
D018093:Gelatinases; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9