RANTES levels in peripheral blood, CSF and contused brain tissue as a marker for outcome in traumatic brain injury (TBI) patients.
BACKGROUND
Traumatic brain injury (TBI) causes activation of several neurochemical and physiological cascades, leading to neurological impairment. We aimed to investigate the level of novel chemokine RANTES in plasma, cerebrospinal fluid (CSF) and contused brain tissue in traumatic brain injury patients and to correlate the expression of this chemokine with the severity of head injury and neurological outcome.


METHODS
This longitudinal case control study was performed on 70 TBI patients over a period of 30 months. Glasgow coma scale (GCS) and Glasgow outcome score were used to assess the severity of head injury and clinical outcome. Level of RANTES was quantified in plasma (n = 60), CSF (N = 10) and contused brain tissue (n = 5). Alterations in the plasma levels on 1st and 5th day following TBI were assessed. Patients were categorized as severe (GCS < 8) (SHI), moderate and mild Head injury (GCS > 8-14). 15 healthy volunteers were taken as the control group.


RESULTS
The median plasma RANTES levels were 971.3 (88.40-1931.1); 999.2 (31.2-2054.9); 471.8 (370.9-631.9) for SHI, MHI and healthy control respectively and showed statistically significant variation (p = 0.005). There was no statistical difference in the mean 1st and 5th day RANTES levels for the SHI group. However, admission RANTES levels were significantly higher in patients who died than those who survived (p = 0.04). Also, RANTES levels were significantly higher in plasma as compared to contused brain tissue and CSF (p = 0.0001).


CONCLUSIONS
This is the first study of its kind which shows that there is significant correlation of admission RANTES levels and early mortality. Another interesting finding was the significant upregulated in the expression of RANTES in plasma, compared to CSF and contused brain tissue following severe TBI.
Departments of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India.
Venencia
V
Albert
Departments of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India. arulselvi.jpnatc@gmail.com.
Arulselvi
A
Subramanian
Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India.
Deepak
D
Agrawal
Department of Emergency Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India.
Sanjeev Kumar
SK
Bhoi
Departments of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India.
Pooja
P
Pallavi
Departments of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, 110022, India.
A K
AK
Mukhopadhayay
D000328:Adult; D015415:Biomarkers / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D001921:Brain / Q000378:metabolism*; D000070642:Brain Injuries, Traumatic / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D016022:Case-Control Studies; D018946:Chemokine CCL5 / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014193:Trauma Centers; D015854:Up-Regulation; D055815:Young Adult
D015415:Biomarkers; C483024:CCL5 protein, human; D018946:Chemokine CCL5
Chemokine; Neuroinflammation; RANTES; TBI