Acute phase response after fatal traumatic brain injury

Area of Science:

• Forensic Pathology
• Biomarker Discovery
• Neurotrauma Research

Background:

• Fatal traumatic brain injury (TBI) triggers inflammatory responses and acute phase reactions.
• Postmortem biomarker analysis offers potential for determining cause of death and survival time after trauma.

Purpose of the Study:

• To investigate the utility of specific pro-inflammatory cytokines and other proteins as postmortem biomarkers in fatal TBI cases.
• To differentiate between TBI fatalities and non-TBI controls, and to assess survival time post-TBI.

Main Methods:

• Cerebrospinal fluid (CSF) and serum samples were collected from 95 adult cadavers (46 TBI, 49 controls) up to 6 days postmortem.
• Levels of interleukin-6 (IL-6), ferritin, soluble tumor necrosis factor receptor type 1, C-reactive protein, and lactate dehydrogenase (LDH) were quantified using immunoassays.

Main Results:

• CSF IL-6, ferritin, and LDH were significantly elevated in TBI cases compared to controls (p < 0.001).
• Serum IL-6 showed significant differences (p < 0.05), and both CSF and serum ferritin distinguished early vs. delayed death post-TBI (p < 0.05).
• Marker levels correlated with survival time, with some influence from the postmortem interval but not age or gender.

Conclusions:

• Ferritin and IL-6 are promising postmortem biomarkers for TBI, providing insights into injury patterns and survival duration.
• These biomarkers can aid forensic investigations as potentially inexpensive and rapid laboratory tests.