title: Serum ceruloplasmin and copper are early biomarkers for traumatic brain injury-associated elevated intracranial pressure.
abstract: High intracranial pressure (ICP) is a prominent secondary pathology after traumatic brain injury (TBI) and is a major contributor to morbidity and mortality. Currently, there are no clinically proven methods for predicting which TBI patients will develop high ICP. In the present study, we examined whether the serum levels of the copper-binding protein ceruloplasmin are differentially altered in patients with elevated ICP (> or =25 mmHg) vs. those whose ICP remained below 20 mmHg throughout the study period. Consistent with its role as an acute-phase reactant, we found that ceruloplasmin levels were significantly increased by 3 days post-TBI compared with healthy volunteers. However, prior to this delayed increase, ceruloplasmin levels during the first 24 hr following injury were found to be significantly reduced in patients who subsequently developed high ICP. This decrease was found to have prognostic accuracy in delineating TBI patients based on their ICP status (cutoff of 140 microg/ml; sensitivity: 87%, specificity: 73%), Likewise, low total serum copper (below 1.32 microg/ml) was also found to be predictive of high ICP (sensitivity 86%, specificity 73%). These results suggest that initial serum ceruloplasmin/copper levels may have diagnostic value in predicting patients at risk for developing high intracranial pressure.
authors.affiliation: Department of Neurobiology and Anatomy, The University of Texas Medical School, Houston, TX 77225, USA. p.dash@uth.tmc.edu
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Dash
authors.forename: John B
authors.initials: JB
authors.lastname: Redell
authors.forename: Georgene
authors.initials: G
authors.lastname: Hergenroeder
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.forename: Guy L
authors.initials: GL
authors.lastname: Clifton
authors.forename: Anthony
authors.initials: A
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000150:complications*; D002570:Ceruloplasmin / Q000378:metabolism*; D003300:Copper / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003300:Copper; D002570:Ceruloplasmin