Amyloid beta 1-42, and tau in cerebrospinal fluid after severe traumatic brain injury
Amyloid beta 1-42, and tau in cerebrospinal fluid after severe traumatic brain injury
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DOI：
10.1212/01.wnl.0000063313.57292.00
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发表时间：
2003-05-13
期刊：
影响因子：
9.9
通讯作者：
Deisenhammer, F
中科院分区：
文献类型：
--
作者：
Franz, G;Beer, R;Deisenhammer, F
目的：探讨脑脊液淀粉样蛋白β 1-42（A β-42）和tau蛋白对颅脑损伤患者预后的预测价值。方法：收集29例重型颅脑外伤患者伤后1 ~ 284天的脑脊液标本。使用夹心ELISA技术测量Abeta-42和tau水平，并与认知障碍和头痛患者的CSF水平进行比较。结果：在所有时间点，创伤性脑损伤（TBI）患者的Abeta-42浓度均显著低于对照组。Abeta-42水平与患者预后存在显著相关性。低于230 pg/mL的临界值时，Abeta-42区分良好结局（格拉斯哥结局评分4和5）和不良结局（格拉斯哥结局评分I至3）的灵敏度为100%，特异性为82%。TBI患者的CSF tau水平显著高于任何对照组。在创伤后1至32天的不同时间点收集多个CSF样本的患者中，tau水平在TBI后早期增加，在创伤后第二周达到峰值，此后缓慢下降。与结果无关，当创伤后超过43天收集CSF时，所有患者的tau水平正常。结论：Abeta-42和tau蛋白可能在脑外伤的病理生理过程中起重要作用。此外，这项研究的结果表明，Abeta-42可能是重型颅脑损伤后恢复的支持性早期预测因子。
Objective: To determine whether CSF amyloid beta 1-42 (Abeta-42) and tau have predictive value for prognosis after head injury. Methods: CSF samples were collected from 29 patients with severe head trauma between 1 and 284 days post-trauma. Abeta-42 and tau levels were measured using sandwich ELISA techniques and compared with CSF levels in patients with cognitive disorders and headache. Results: At all time points, concentrations of Abeta-42 were significantly lower in patients with traumatic brain injury (TBI) than in control groups. A significant correlation existed for Abeta-42 levels and outcome of patients. Below a cutoff of 230 pg/mL, the sensitivity of Abeta-42 to discriminate between good outcome (Glasgow Outcome Score 4 and 5) and poor outcome (Glasgow Outcome Score I through 3) was 100% at a specificity of 82%. CSF tau levels were significantly higher in patients with TBI than in any control group. In patients with multiple CSF samples collected at various time points between 1 and 32 days after the trauma, tau levels increased early after TBI, peaked in the second week post-trauma, and slowly decreased thereafter. Independent of outcome, all patients had normal tau levels when CSF was collected more than 43 days post-trauma. Conclusions: Abeta-42 and tau may play a potential role in the pathophysiology of TBI. Furthermore, the results of this study suggest that Abeta-42 may be a supportive early predictor for recovery after severe head injury.