Moderate and severe traumatic brain injury induce early overexpression of systemic and brain gelatinases

Anna Vilalta, Juan Sahuquillo, Anna Rosell, Maria A. Poca, Marilyn Riveiro, Joan Montaner

Research output: Contribution to journalArticleResearchpeer-review

74 Citations (Scopus)

Abstract

Objective: Recent experimental evidence suggests that matrix metalloproteinases (MMPs) are implicated in the pathophysiology of traumatic brain injury (TBI) by increasing blood-brain barrier permeability and exacerbating posttraumatic edema. We examined the acute profile of MMP-2 and MMP-9 in the plasma of patients with moderate or severe TBI and in the brain extracellular fluid (ECF). Design: Prospective observational study. Setting: Neurotraumatology intensive care unit of a tertiary university hospital. Patients: Twenty patients with moderate or severe TBI were included and three groups were used as controls: 20 patients with a mild head injury and normal CT scan, 15 moderate polytrauma patients without TBI, and 20 healthy volunteers. Interventions: Plasma samples were collected within the first 12 h and at 24 h post-injury. Simultaneous brain microdialysate and plasma samples were obtained in four moderate-severe TBI patients at additional timepoints: 48, 72, and 96 h post-TBI. Measurements and main results: Gelatinases (MMP-2 and MMP-9) were measured by gelatin zymography. A significant increase in plasma gelatinases was observed at baseline when compared with healthy volunteers in the study group. This early increase was followed by a significant decrease at 24 h post-injury. Brain microdialysis samples presented a similar time profile as plasma samples for both gelatinases. Conclusions: High levels of gelatinases were found in plasma and brain ECF in the early phase of TBI, indicating that both local and systemic trauma-induced upregulation of gelatinases in the acute phase might play an important role in the pathophysiology of TBI and could be a future therapeutic target. © 2008 Springer-Verlag.
Original languageEnglish
Pages (from-to)1384-1392
JournalIntensive Care Medicine
Volume34
DOIs
Publication statusPublished - 1 Aug 2008

Keywords

  • Blood-brain barrier
  • Brain extracellular fluid
  • Gelatinases
  • Matrix metalloproteinases
  • Microdialysis
  • Neuroinflammation
  • Traumatic brain injury

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