Serial plasma deoxyribonucleic acid levels as predictors of outcome in acute traumatic brain injury.
Increased plasma deoxyribonucleic acid (DNA) levels may be associated with disease severity after acute traumatic brain injury (TBI). This study posits that increased plasma DNA levels in acute TBI are predictive of outcome. Both serial plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) levels were examined in 88 consecutive patients with acute TBI and 66 control subjects. Additional samples were obtained on day 4 and day 7. Results showed that plasma nDNA and mtDNA on admission were significantly increased in patients with TBI compared with controls. Plasma nDNA, but not plasma mtDNA, levels in patients with acute TBI significantly correlated with Glasgow Coma Scale (GCS) score and Injury Severity Score (ISS) on presentation. Plasma nDNA increased significantly from day 1 to day 7 in patients with poor outcome. Its levels on presentation were independently associated with outcome and higher levels (cutoff value >72.95 ng/mL) were associated with poorer outcomes. These findings suggest plasma nDNA levels reflect the severity of cerebral damage and can be considered a neuropathologic marker of patients with acute TBI. Further studies with bigger patient populations are warranted for better unbiased comparison.
1 Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan .
Hung-Chen
HC
Wang
Yu-Jun
YJ
Lin
Nai-Wen
NW
Tsai
Ben Yu-Jih
BY
Su
Chia-Te
CT
Kung
Wu-Fu
WF
Chen
Aij-Lie
AL
Kwan
Cheng-Hsien
CH
Lu
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000097:blood* / Q000523:psychology; D002467:Cell Nucleus / Q000737:chemistry; D003422:Critical Care; D004247:DNA / Q000097:blood*; D004272:DNA, Mitochondrial / Q000097:blood; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D004272:DNA, Mitochondrial; D004247:DNA
mitochondrial DNA; nuclear DNA; outcome; traumatic brain injury