Apolipoprotein E polymorphism and gender difference in outcome after severe traumatic brain injury

Area of Science:

• Neuroscience
• Genetics
• Trauma Surgery

Background:

• Traumatic brain injury (TBI) is a leading cause of death and disability in young individuals.
• Advances in neurocritical care have improved TBI outcomes.
• The influence of apolipoprotein E (APOE) genotype on TBI prognosis requires further prospective investigation, particularly in Northern European populations.

Purpose of the Study:

• To prospectively investigate the association between APOE genotype and outcomes following TBI in a Northern European cohort.
• To determine if the APOE epsilon4 allele impacts functional recovery and survival rates after TBI.

Main Methods:

• A cohort of 96 patients with severe TBI (Glasgow Coma Scale ≤8) was consecutively enrolled.
• APOE genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism.
• Patient outcomes were assessed at one year using the Glasgow Outcome Scale Extended (GOSE), NIH Stroke Scale (NIHSS), and Barthel Index.

Main Results:

• The APOE epsilon4 allele was present in 26 patients and absent in 70.
• Patients carrying the APOE epsilon4 allele exhibited significantly worse outcomes compared to those without the allele.
• A gender-specific effect was observed: males with APOE epsilon4 had poorer outcomes, whereas females did not show this difference.

Conclusions:

• The APOE epsilon4 genotype is a significant predictor of worse outcomes in patients with TBI.
• Gender modifies the impact of APOE epsilon4 on TBI prognosis, with males being more adversely affected.
• Genetic variations, such as APOE polymorphism, play a role in determining individual recovery trajectories after TBI.