Increases in bcl-2 protein in cerebrospinal fluid and evidence for programmed cell death in infants and children after severe traumatic brain injury

被引:80
作者
Clark, RSB
Kochanek, PM
Adelson, PD
Bell, MJ
Carcillo, JA
Chen, M
Wisniewski, SR
Janesko, K
Whalen, MJ
Graham, SH
机构
[1] Childrens Hosp Pittsburgh, Div Pediat Crit Care, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15213 USA
[2] Childrens Hosp Pittsburgh, Dept Pediat, Pittsburgh, PA 15213 USA
[3] Childrens Hosp Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15213 USA
[4] Childrens Hosp Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15213 USA
[5] Childrens Hosp Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA
[6] Univ Pittsburgh, Sch Med, Safar Ctr Resuscitat Res, Pittsburgh, PA USA
[7] VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA
关键词
D O I
10.1067/mpd.2000.106903
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives: To determine whether bcl-2, a protein that inhibits apoptosis, would be increased in cerebrospinal fluid (CSF) in infants and children after traumatic brain injury (TBI) and to examine the association of bcl-2 concentration with clinical variables. Study design: Bcl-2 was measured in CSF from 23 children (aged 2 months-16 years) with severe TBI and from 19 children without TBI or meningitis (control subjects) by enzyme-linked immunosorbent assay CSF oligonucleosome concentration was also determined as a marker of DNA degradation. Brain samples from 2 patients undergoing emergent decompressive craniectomies were analyzed for bcl-2 with Western blot and for DNA fragmentation with TUNEL (terminal deoxynucleotidyl-transerase mediated biotin-dUTP nick-end labeling). Results: CSF bcl-2 concentrations were increased in patients with TBI versus control subjects (P = .01). Bcl-2 was increased in patients with TBI who survived versus those who died (P = .02). CSF oligonucleosome concentration tended to be increased after TBI (P = .07) and was not associated with bcl-2. Brain tissue samples showed an increase in bcl-2 in patients with TBI versus adult brain bank control samples and evidence of DNA fragmentation within cells with apoptotic morphology Conclusions: Bcl-2 may participate in the regulation of cell, death after TBI in infants and children. The increase in bcl-2 seen in patients who survived is consistent with a protective role for this anti-apoptotic protein after TBI.
引用
收藏
页码:197 / 204
页数:8
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