title: What are the progesterone-induced changes of the outcome and the serum markers of injury, oxidant activity and inflammation in diffuse axonal injury patients?
abstract: To permit appropriate targeted therapy, the present clinical study was aimed to investigate the effects of progesterone on the outcome and the serum markers of injury, oxidant activity and inflammation in diffuse axonal injury (DAI). Forty-eight male DAI patients were divided into two groups (control and progesterone). Progesterone group received progesterone in dose of 1mg/kg per 12h for five days. The outcome was investigated using Extended Glasgow Outcome Scale (GOS-E) and functional independence measure (FIM). The markers of inflammation [interleukin-1β (IL-1β), IL-6, transforming growth factor-β1 (TGF-β1)], injury (brain protein of S-100B), and oxidant activity [malondialdehyde (MDA)] were evaluated in the serum of the patients. Higher GOS-E and FIM scores were observed in progesterone group at the six-month follow-up (P<0.05 and P<0.01, respectively). Meanwhile, a reduction in the serum levels of IL-1β, MDA and S-100B was noticed in progesterone group 24h after injury (P<0.05, P<0.001 and P<0.05, respectively), and there was an increase in serum levels of IL-6 and TGF-β1 (P<0.01 and P<0.05, respectively). Also, lower levels of MDA and S-100B, and higher levels of TGF-β1 were observed in progesterone group six days after injury (P<0.05). According to these findings, progesterone may improve the outcome in DAI patients probably through modulation in the levels of cytokines, and reduction in the injury and oxidant activity.
authors.affiliation: Dept. of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Behshad
authors.initials: B
authors.lastname: Mofid
authors.affiliation: Physiology Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. Electronic address: soltaniy@yahoo.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Soltani
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khaksari
authors.affiliation: Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Shahrokhi
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Nouzar
authors.initials: N
authors.lastname: Nakhaee
authors.affiliation: Dept. of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Karamouzian
authors.affiliation: Dept. of Intensive Care Unit, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ahmadinejad
authors.affiliation: Dept. of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Maiel
authors.affiliation: Physiology Research Center, Institute of Neuropharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Payam
authors.initials: P
authors.lastname: Khazaeli
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood; D020833:Diffuse Axonal Injury / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018696:Neuroprotective Agents / Q000097:blood / Q000494:pharmacology*; D011374:Progesterone / Q000097:blood / Q000494:pharmacology*; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D016037:Single-Blind Method
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D016207:Cytokines; D018696:Neuroprotective Agents; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; D011374:Progesterone; D008315:Malondialdehyde
keywords: Diffuse axonal injury; Interleukin-1β; Interleukin-6; Oxidant activity; Progesterone; Transforming growth factor-β1