Polymorphonuclear (PMN) elastase in patients after severe traumatic brain injury

Lukas Kurt Postl*, Viktoria Bogner, Martijn van Griensven, Marc Beirer, Karl Georg Kanz, Christoph Egginger, Peter Biberthaler, Chlodwig Kirchhoff

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Data on PNM elastase levels in cerebrospinal fluid following traumatic brain injury (TBI) in humans are not available in the literature. Therefore, the aim of this prospective study was to evaluate the dynamics of PMN elastase in the cerebrospinal fluid (CSF) of patients after TBI.

METHODS: Patients suffering from isolated, closed TBI, presenting with an initial Glasgow coma score ≤ 8 and with intracerebral hemorrhage on the initial cranial computed tomography scan (performed within 90 min after TBI) were enrolled. CSF and blood samples were obtained immediately, 12 h, 24 h, 48 h, and 72 h after admission. ELISA testing was used to quantify the PMN elastase levels in CSF. In addition, the ratio of CSF albumin to serum albumin was calculated to evaluate the role of the blood-cerebrospinal fluid barrier (BCSFB). As controls, CSF samples were taken from patients receiving spinal anesthesia for elective orthopedic surgery of the lower extremity.

RESULTS: Twenty-three patients meeting the inclusion criteria and ten control patients were enrolled. The PMN elastase showed a significant elevation at 48 and 72 h after TBI. When comparing the PMN elastase levels of patients with intact BCSFB to patients with defective BCSFB, there was no significant difference for the respective observation points.

CONCLUSIONS: This is the first study to demonstrate that the PMN elastase levels in CSF significantly increased in the early posttraumatic phase (48 h and 72 h after TBI) in patients. The function of the BCSFB showed no significant influence on the PMN levels.

Original languageEnglish
Article number44
Pages (from-to)44
Number of pages6
JournalEuropean Journal of Medical Research
Volume23
Issue number1
DOIs
Publication statusPublished - 15 Sep 2018
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers/blood
  • Blood-Brain Barrier
  • Brain Injuries, Traumatic/complications
  • Case-Control Studies
  • Disease Progression
  • Female
  • Humans
  • Intracranial Hemorrhage, Traumatic/cerebrospinal fluid
  • Leukocyte Elastase/blood
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Young Adult
  • Traumatic brain injury
  • TBI
  • INHIBITOR
  • Alpha 1-proteinase
  • NEUTROPHIL ELASTASE
  • Polymorphonuclear elastase
  • PMN
  • SIVELESTAT
  • ELISA

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