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Soluble adhesion molecules in CSF are increased in children with severe head injury
M J Whalen1, T M Carlos, P M Kochanek
1Department of Anesthesiology and Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh, Pennsylvania 15260, USA.
Insights
Traumatic brain injury (TBI) in children involves acute inflammation, indicated by elevated P-selectin and intercellular adhesion molecule-1 (ICAM-1) in cerebrospinal fluid (CSF). These markers are linked to abuse and younger age, suggesting specific inflammatory roles.
Area of Science:
- Neuroscience
- Immunology
- Pediatrics
Background:
- Leukocyte-endothelial adhesion molecules are crucial for acute inflammation.
- These molecules are expressed in the brain during the inflammatory response to traumatic brain injury (TBI).
Purpose of the Study:
- To measure concentrations of specific adhesion molecules in cerebrospinal fluid (CSF) of children with severe TBI.
- To compare these levels with those in children suffering from bacterial meningitis.
- To investigate associations between adhesion molecule levels and clinical factors like child abuse and age.
Main Methods:
- CSF samples were collected from children with severe TBI (Glasgow Coma Scale score < 8) and compared to controls with bacterial meningitis.
- Concentrations of P-selectin, ICAM-1, E-selectin, L-selectin, and VCAM-1 were measured.
- Univariate and multivariate regression analyses were employed to identify significant associations.
Main Results:
- P-selectin levels were elevated in children with TBI compared to those with meningitis and controls.
- CSF P-selectin showed associations with child abuse and younger age (< 4 years).
- CSF intercellular adhesion molecule-1 (ICAM-1) demonstrated a significant, independent association with child abuse.
Conclusions:
- The findings support a distinct acute inflammatory component in pediatric TBI.
- P-selectin and ICAM-1 emerge as key molecules in the inflammatory response following TBI in children.
- Future research should explore the roles of P-selectin and ICAM-1 in TBI-related injury and repair mechanisms.
Abstract:
Leukocyte-endothelial adhesion molecules, critical to the development of acute inflammation, are expressed in brain as part of the acute inflammatory response to traumatic brain injury (TBI). We measured the concentrations of the adhesion molecules P-selectin, ICAM-1, E-selectin, L-selectin, and VCAM-1 in ventricular cerebrospinal fluid (CSF) from children with severe TBI (Glasgow coma score < 8) and compared these findings with those from children with bacterial meningitis. P-selectin, an adhesion molecule associated with ischemia/reperfusion, was increased in children with TBI versus meningitis and control. Univariate and multivariate regression analyses demonstrated associations between CSF P-selectin and child abuse and age of < 4 years, and a significant, independent association between CSF intercellular adhesion molecule-1 (ICAM-1) and child abuse. These results are consistent with a specific acute inflammatory component to TBI in children. Future studies of secondary injury mechanisms and therapy after TBI should assess on the roles of P-selectin and ICAM-1 in injury and repair processes in brain after TBI.