title: Changes of PACAP level in cerebrospinal fluid and plasma of patients with severe traumatic brain injury.
abstract: PACAP has well-known neuroprotective potential including traumatic brain injury (TBI). Its level is up-regulated following various insults of the CNS in animal models. A few studies have documented alterations of PACAP levels in human serum. The time course of post-ictal PACAP levels, for example, show correlation with migraine severity. Very little is known about the course of PACAP levels following CNS injury in humans and the presence of PACAP has not yet been detected in cerebrospinal fluid (CSF) of subjects with severe TBI (sTBI). The aim of the present study was to determine whether PACAP occurs in the CSF and plasma (Pl) of patients that suffered sTBI and to establish a time course of PACAP levels in the CSF and Pl. Thirty eight subjects with sTBI were enrolled with a Glasgow Coma Scale ≤8 on admission. Samples were taken daily, until the time of death or for maximum 10 days. Our results demonstrated that PACAP was detectable in the CSF, with higher concentrations in patients with TBI. PACAP concentrations markedly increased in both Pl and CSF in the majority of patients 24-48h after the injury stayed high thereafter. In cases of surviving patients, Pl and CSF levels displayed parallel patterns, which may imply the damage of the blood-brain barrier. However, in patients, who died within the first week, Pl levels were markedly higher than CSF levels, possibly indicating the prognostic value of high Pl PACAP levels.
authors.affiliation: Department of Neurosurgery, University of Pecs, Pecs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Bukovics
authors.affiliation: MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary; Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary; MTA-PTE Lendulet PACAP Research Group, Pecs, Hungary; Department of Anatomy, University of Pecs, Pecs, Hungary. Electronic address: endre.czeiter@gmail.com.
authors.forename: Endre
authors.initials: E
authors.lastname: Czeiter
authors.affiliation: Department of Neurosurgery, University of Pecs, Pecs, Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Amrein
authors.affiliation: Department of Neurosurgery, University of Pecs, Pecs, Hungary.
authors.forename: Noemi
authors.initials: N
authors.lastname: Kovacs
authors.affiliation: Department of Neurosurgery, University of Pecs, Pecs, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Pal
authors.affiliation: MTA-PTE Lendulet PACAP Research Group, Pecs, Hungary; Department of Anatomy, University of Pecs, Pecs, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tamas
authors.affiliation: Department of Pharmacology and Pharmacotherapy, University of Pecs, Pecs, Hungary.
authors.forename: Terez
authors.initials: T
authors.lastname: Bagoly
authors.affiliation: Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary; Department of Pharmacology and Pharmacotherapy, University of Pecs, Pecs, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Helyes
authors.affiliation: Department of Neurosurgery, University of Pecs, Pecs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary; Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Buki
authors.affiliation: MTA-PTE Lendulet PACAP Research Group, Pecs, Hungary; Department of Anatomy, University of Pecs, Pecs, Hungary.
authors.forename: Dora
authors.initials: D
authors.lastname: Reglodi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D051219:Pituitary Adenylate Cyclase-Activating Polypeptide / Q000097:blood* / Q000134:cerebrospinal fluid*; D055815:Young Adult
chemical_list: D051219:Pituitary Adenylate Cyclase-Activating Polypeptide
keywords: Blood–brain barrier; Cerebrospinal fluid; Endogenous PACAP; Neuroprotective; Plasma; Traumatic brain injury