Modulating effect of apolipoprotein E polymorphisms on secondary brain insult and outcome after childhood brain trauma.
OBJECTIVE
The aim of this study was to determine the relationship between apolipoprotein E (APO E) alleles, the amount of cerebral perfusion pressure (CPP) insult and outcome in children after brain trauma.


METHODS
In a prospective two-centre case-control study, the APO E genotypes of 65 critically ill children admitted after brain trauma were correlated with age-related CPP insult quantification, conscious state at the time of discharge from intensive care and global outcome at 6 months post-injury. One hundred sixty healthy age- and sex-matched children were genotyped as controls.


RESULTS
The CPP insult level among the e4 carriers with poor outcome was significantly less than the non-e4 carriers (p=0.03). Homozygotic e3 patients with good recovery did so despite having suffered nearly 26 times more CPP insult than those who were not e3 homzygous (p=0.02).


CONCLUSIONS
Different APO E alleles may potentially affect cerebral ischaemic tolerance differently in children after brain trauma.
Section of Child Life & Health, University of Edinburgh, 20 Sylvan Place, Edinburgh, EH 9 1LF, UK. mils.lo@doctors.org.uk
T Y M
TY
Lo
P A
PA
Jones
I R
IR
Chambers
T F
TF
Beattie
R
R
Forsyth
A D
AD
Mendelow
R A
RA
Minns
D000293:Adolescent; D000483:Alleles; D053329:Apolipoprotein E2 / Q000235:genetics; D053318:Apolipoprotein E3 / Q000235:genetics; D053327:Apolipoprotein E4 / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics*; D001930:Brain Injuries / Q000235:genetics* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D019586:Intracranial Hypertension / Q000235:genetics / Q000503:physiopathology; D008297:Male; D011110:Polymorphism, Genetic; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function / Q000235:genetics / Q000502:physiology
D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D053327:Apolipoprotein E4; D001057:Apolipoproteins E