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Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
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vCSF Danger-associated Molecular Patterns After Traumatic and Nontraumatic Acute Brain Injury: A Prospective Study.

Carlos A Santacruz1,2, Jean-Louis Vincent1, Jorge Duitama3

  • 1Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Journal of Neurosurgical Anesthesiology
|May 15, 2023
PubMed
Summary

Danger-associated molecular patterns (DAMPs) in cerebrospinal fluid differ between traumatic and nontraumatic acute brain injuries. DAMP expression correlates with severe intracranial hypertension but not patient outcomes.

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Area of Science:

  • Neuroscience
  • Biochemistry
  • Immunology

Background:

  • Danger-associated molecular patterns (DAMPs) may contribute to poor outcomes in acute brain injury (ABI).
  • Understanding DAMPs' role is crucial for developing targeted therapies.
  • Investigating DAMPs in cerebrospinal fluid offers insights into brain injury pathophysiology.

Purpose of the Study:

  • To investigate the differential expression of DAMPs in cerebrospinal fluid following traumatic versus nontraumatic ABI.
  • To determine the association between DAMP expression and intracranial hypertension, ICU mortality, and neurological outcomes.

Main Methods:

  • Ventricular cerebrospinal fluid (vCSF) samples were collected from 50 ABI patients over 5 days.
  • vCSF protein expression differences were analyzed using linear models and functional network analysis.
  • Associations between DAMPs and clinical factors like intracranial pressure were assessed.

Main Results:

  • A distinct network of 6 DAMPs was differentially expressed in traumatic ABI compared to nontraumatic ABI.
  • Severe intracranial hypertension (≥30 mm Hg) was associated with differential expression of 38 DAMPs.
  • No significant relationships were found between DAMP expression and ICU mortality or 3-month neurological outcomes.

Conclusions:

  • vCSF DAMP expression patterns can distinguish between traumatic and nontraumatic ABI.
  • Elevated DAMP expression is linked to increased episodes of severe intracranial hypertension post-ABI.
  • DAMPs may serve as biomarkers for specific ABI types and intracranial pressure severity.