Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients
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Chandrika Nayak
Abstract
Background: Oxidative stress is said to strongly influence the neurological recovery of patients following a severe head injury. Estimation of the markers of oxidative stress in the blood of such patients can hence aid in predicting the prognosis of head injury.
Methods: Erythrocyte thiobarbituric acid-reactive substances (TBARS) and plasma ceruloplasmin (CP) levels were estimated in 24 severe head-injury patients on days 1, 7 and 21 of the post-traumatic period and compared with levels in 25 healthy age- and sex-matched controls. These parameters reflecting oxidative stress status were related to the Glasgow Coma Scale (GCS) scores of patients noted at the same time points of the study period.
Results: Lipid peroxidation as indicated by increased levels of erythrocyte TBARS remained significantly elevated in severe head injury patients compared to controls on day 1 (p<0.001), day 7 (p<0.001) and 21 (p<0.001) of the post-traumatic period. Plasma CP levels remained significantly elevated (p<0.001) at these three time points compared to controls. The significant decrease in lipid peroxidation products (p<0.01) and significant increase in CP levels (p<0.001) on day 21 compared to day 1 in head injury patients correlated well with the significant improvement in GCS scores of patients on day 21 compared to day 1 (p<0.05).
Conclusion: The above results could account for the adaptation of the study patients to severe oxidative stress, as evidenced by their clinical recovery trend during the study period.
References
1. Muizelaar JP, Marmarou A, Young HF, Choi SC, Wolf A, Schneider RL, et al. Improving the outcome of severe head injury with the oxygen radical scavenger polyethylene glycol-conjugated superoxide dismutase: a Phase II trial. J Neurosurg 1993; 78:375–82.10.3171/jns.1993.78.3.0375Search in Google Scholar
2. Regner A, Alves LB, Chemale I, Costa MS, Friedman G, Achaval M, et al. Neurochemical characterization of traumatic brain injury in humans. J Neurotrauma 2001; 18:783–92.10.1089/089771501316919148Search in Google Scholar
3. Kontos HA, Polivshock JT. Oxygen radicals in brain injury. CNS Trauma 1986; 3:257–63.Search in Google Scholar
4. Hall ED, Braughler JM. Central nervous system trauma and stroke: Part II. Physiological and pharmacological evidence for the involvement of oxygen radicals and lipid peroxidation. Free Radic Biol Med 1989; 6:303–13.10.1016/0891-5849(89)90057-9Search in Google Scholar
5. Oliver CN, Starke RPE, Stadtman ER, Liu GJ, Carney JM, Floyd RA. Oxidative damage to brain proteins, loss of glutamine synthase activity and production of free radicals during ischemia/reperfusion-induced injury to gerbil brain. Proc Natl Acad Sci USA 1990; 87:5144–47.10.1073/pnas.87.13.5144Search in Google Scholar
6. McIntosh TK. Neurochemical sequelae of traumatic brain injury: therapeutic implications. Cereb Brain Metab Rev 1994; 6:109–62.Search in Google Scholar
7. Halliwell B. Free radicals, reactive oxygen species and human disease: a critical evaluation with special reference to atherosclerosis. Br J Exp Pathol 1989; 70:737–57.Search in Google Scholar
8. Cherubini A, Polidori C, Benedetti C, Ercolani S, Senin U, Mecocci P. Association between ischemic stroke and increased oxidative stress. Presented at the 2nd virtual Congress of Cardiology, 2001.Search in Google Scholar
9. Evans PH. Free radicals in brain metabolism and pathology. Br Med Bull 1993; 49:577–87.10.1093/oxfordjournals.bmb.a072632Search in Google Scholar
10. Reiter RJ. Oxidative processes and antioxidative defence mechanisms in the aging brain. FASEB J 1995; 9:526–33.10.1096/fasebj.9.7.7737461Search in Google Scholar
11. Paolin A, Lorella N, Gaetani P, Riccardo RYB, Orietta P, Fulvio M. Oxidative damage after severe head injury and its relationship to neurological outcome. Neurosurgery 2002; 51:949–54.Search in Google Scholar
12. Young B, Ott L, Beard D, Dempsey RJ, Tibbs PA, McClain CJ. The acute phase response of the brain injured patient. J Neurosurg 1988; 69:375–80.10.3171/jns.1988.69.3.0375Search in Google Scholar
13. Moskopp D, Stahle C, Wassmann H. Problems of the Glasgow Coma Scale with early intubated patients. Neurosurg Rev 1995; 18:253–57.10.1007/BF00383876Search in Google Scholar
14. Jain SK, Robert MV, John D, John JH. Erythrocyte membrane lipid peroxidation and glycosylated hemoglobin in diabetes. Diabetes 1989; 38:1539–43.10.2337/diab.38.12.1539Search in Google Scholar
15. Tentori L, Salvati AM. Hemoglobinometry in human blood. Methods Enzymol 1981; 76:707–15.10.1016/0076-6879(81)76152-4Search in Google Scholar
16. Ravin HA. An improved colorimetric enzymatic assay of ceruloplasmin. J Lab Clin Med 1961; 58:161–8.Search in Google Scholar
17. Gururaj G. Epidemiology of traumatic brain injuries: Indian scenario. Neurol Res 2002; 24:24–8.10.1179/016164102101199503Search in Google Scholar
18. Braughler JM, Hall ED. Central nervous system trauma and stroke: biochemical considerations for oxygen radical formation and lipid peroxidation. Free Radic Biol Med 1989; 6:289–301.10.1016/0891-5849(89)90056-7Search in Google Scholar
19. Tyurin VA, Tyurina YY, Borisenko GG, Sokolova TV, Ritov VB, Quinn PJ, et al. Oxidative stress following traumatic brain injury in rats: quantitation of biomarkers and detection of free radical intermediates. J Neurochem 2000; 75:2178–89.10.1046/j.1471-4159.2000.0752178.xSearch in Google Scholar
20. Nishio S, Yunoki M, Noguchi Y, Kawauchi M, Asari S, Ohmoto T. Detection of lipid peroxidation and hydroxyl radicals in brain contusion of rats. Acta Neurochir Suppl (Wein) 1997; 70:84–86.10.1007/978-3-7091-6837-0_26Search in Google Scholar
21. Shohami E, Gati I, Yannai BE, Trembovler V, Kohen R. Closed head injury in the rat induces whole body oxidative stress: overall reducing antioxidant profile. J Neurotrauma 1999; 16:365–76.10.1089/neu.1999.16.365Search in Google Scholar
22. Rao GM. Free radical toxicity and antioxidants in patients with brain tumor. Ph.D thesis. Manipal, India: Manipal Academy of Higher Education, 1998.Search in Google Scholar
23. Esterbauer H, Schaur RJ, Zollner H. Chemistry and biochemistry of 4-hydroxynonenal, malondialdehyde and related aldehydes. Free Radic Biol Med 1991; 11:81–128.10.1016/0891-5849(91)90192-6Search in Google Scholar
24. Uchida K, Stadtman E. Modification of histidine residues in proteins by reaction with 4-hydroxynonenal. Proc Natl Acad Sci USA 1992; 89:4544–8.10.1073/pnas.89.10.4544Search in Google Scholar
25. Siems WG, Sommerburg O, Grune T. Erythrocyte free radical and energy metabolism. Clin Nephrol 2000; 53(Suppl 9):17–23.Search in Google Scholar
26. Sato M, Bremner I. Oxygen free radicals and metallothionein. Free Radic Biol Med 1993; 14:325–37.10.1016/0891-5849(93)90029-TSearch in Google Scholar
27. DeSilva D, Aust SD. Ferritin and ceruloplasmin in oxidative damage: review of recent findings. Can J Physiol Pharmacol 1993; 71:715–20.10.1139/y93-107Search in Google Scholar PubMed
28. Goldstein IM, Kaplan HB, Edelson HS, Weissmann G. Ceruloplasmin: an acute phase reactant that scavenges oxygen-derived free radicals. Ann NY Acad Sci 1982; 389:368–79.10.1111/j.1749-6632.1982.tb22150.xSearch in Google Scholar PubMed
29. Atanasiu RL, Stea D, Mateescu MA, Vergely C, Dalloz F, Briot F, et al. Direct evidence of ceruloplasmin antioxidant properties. Mol Cell Biochem 1998; 189:127–35.10.1023/A:1006945713860Search in Google Scholar
30. Kuhlow CJ, Krady JK, Basu A, Levison SW. Astrocytic ceruloplasmin expression, which is induced by IL-1 beta and by traumatic brain injury, increases in the absence of the IL-1 type 1 receptor. Glia 2003; 44:76–84.10.1002/glia.10273Search in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
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- Preanalytical variability: the dark side of the moon in laboratory testing
- Clinical relevance of biological variation: the lesson of brain natriuretic peptide (BNP) and NT-proBNP assay
- Hepatorenal syndrome
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- The exponentially weighted moving average (EWMA) rule compared with traditionally used quality control rules
- Intermethod calibration of alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) results: application to Fibrotest® and Actitest® scores
- Comparison of TEST 1 with SRS 100 and ICSH reference method for the measurement of the length of sedimentation reaction in blood
- Multicenter evaluation of the interference of hemoglobin, bilirubin and lipids on Synchron LX-20 assays
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- Pyrosequencing protocol requiring a unique biotinylated primer
- Detection of antibodies against 60-, 65- and 70-kDa heat shock proteins in paediatric patients with various disorders using Western blotting and ELISA
- Quantitative determination of erythrocyte folate vitamer distribution by liquid chromatography-tandem mass spectrometry
- Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients
- Stepwise strategies in analysing haematuria and leukocyturia in screening
- Elevation of serum cerebral injury markers correlates with serum choline decline after coronary artery bypass grafting surgery
- Drug screening in urine by cloned enzyme donor immunoassay (CEDIA) and kinetic interaction of microparticles in solution (KIMS): a comparative study
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- Physiological matrix metalloproteinase (MMP) concentrations: comparison of serum and plasma specimens
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- The dilemma of invasive and non-invasive investigations for adult and paediatric non-alcoholic fatty liver disease: has the time come for a new biochemical marker?
- Is cystatin C a reliable renal marker in trauma?
- On the independence of intraindividual reference values
- Sixth International Symposium on Molecular Diagnostics, Graz, Austria, May 25-27, 2006
Articles in the same Issue
- Natriuretic peptides and evidence-based quality specifications
- Preanalytical variability: the dark side of the moon in laboratory testing
- Clinical relevance of biological variation: the lesson of brain natriuretic peptide (BNP) and NT-proBNP assay
- Hepatorenal syndrome
- Modified Levey-Jennings charts for calculated laboratory tests
- Increased free malondialdehyde concentrations in smokers normalise with a mixed fruit and vegetable juice concentrate: a pilot study
- The exponentially weighted moving average (EWMA) rule compared with traditionally used quality control rules
- Intermethod calibration of alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) results: application to Fibrotest® and Actitest® scores
- Comparison of TEST 1 with SRS 100 and ICSH reference method for the measurement of the length of sedimentation reaction in blood
- Multicenter evaluation of the interference of hemoglobin, bilirubin and lipids on Synchron LX-20 assays
- Technical evaluation of the Beckman Coulter OV-Monitor (CA 125 antigen) immunoassay
- Erythrocyte membrane Na+,K+-ATPase and Mg2+-ATPase activities in subjects with methylenetetrahydrofolate reductase (MTHFR) 677 C→T genotype and moderate hyperhomocysteinaemia. The role of L-phenylalanine and L-alanine
- Matrix metalloproteinases and their inhibitors in different acute stroke subtypes
- Pyrosequencing protocol requiring a unique biotinylated primer
- Detection of antibodies against 60-, 65- and 70-kDa heat shock proteins in paediatric patients with various disorders using Western blotting and ELISA
- Quantitative determination of erythrocyte folate vitamer distribution by liquid chromatography-tandem mass spectrometry
- Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients
- Stepwise strategies in analysing haematuria and leukocyturia in screening
- Elevation of serum cerebral injury markers correlates with serum choline decline after coronary artery bypass grafting surgery
- Drug screening in urine by cloned enzyme donor immunoassay (CEDIA) and kinetic interaction of microparticles in solution (KIMS): a comparative study
- Release of anandamide from blood cells
- Rapid decrease in plasma D-lactate as an early potential predictor of diminished 28-day mortality in critically ill septic shock patients
- Evaluation of an immunoassay of whole blood sirolimus in pediatric transplant patients in comparison with high-performance liquid chromatography/tandem mass spectrometry
- Sample processing and its preanalytical impact on the measurement of circulating matrix metalloproteinases
- Physiological matrix metalloproteinase (MMP) concentrations: comparison of serum and plasma specimens
- Importance of the functional sensitivity determination of a serum hyaluronic acid assay for the prediction of liver fibrosis in patients with features of the metabolic syndrome
- The dilemma of invasive and non-invasive investigations for adult and paediatric non-alcoholic fatty liver disease: has the time come for a new biochemical marker?
- Is cystatin C a reliable renal marker in trauma?
- On the independence of intraindividual reference values
- Sixth International Symposium on Molecular Diagnostics, Graz, Austria, May 25-27, 2006
