Generation of procoagulant microparticles in cerebrospinal fluid and peripheral blood after traumatic brain injury
Generation of procoagulant microparticles in cerebrospinal fluid and peripheral blood after traumatic brain injury
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DOI：
10.1097/ta.0b013e31816493ad
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发表时间：
2008-03-01
影响因子：
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通讯作者：
Dabadie, Philippe
中科院分区：
文献类型：
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作者：
Morel, Nicolas;Morel, Olivier;Dabadie, Philippe
背景：创伤性脑损伤（TBI）可引起细胞损伤。促凝血微粒（MP）是细胞刺激的可靠标记。本研究的目的是调查严重 TBI 患者脑脊液 (CSF) 和血浆中促凝血 MP 的产生。材料：通过功能性凝血酶原酶测定（i）在创伤当天，（ii）在 10 天的随访期间对 16 名严重 TBI 患者的 CSF 和血浆 MP 进行定量，并与对照样本进行比较。用特异性抗体捕获后确定 NIP 的细胞起源。 结果：严重 TBI 患者的脑脊液和血浆显示，与创伤当天的对照样本相比，MP 的生成显着增加（脑脊液：4.5 +/- 1.8 与 0.83 +/- 0.28 纳摩尔 PhtdSer 当量；p = 0.01，血浆为 4.1 +/- 3.7 与 2.3 +/- 0.19纳摩尔PhtdSer当量； p = 0.02）。脑脊液中促凝 MP 主要来源于血小板和内皮细胞。 TBI 后 10 天，CSF 中的 MP 显着下降。在脑脊液中，两名临床结果不佳的患者持续产生了促凝血 MP。在随访过程中，三名患有播散性血管内凝血病的患者在血流中检测到促凝血 MEN 含量升高。结论：严重 TBI 后，脑脊液和血浆中会产生促凝血 MP，证明血小板和内皮细胞活化。脑脊液中持续产生促凝 MP 可能会导致临床结果不佳。
Background: Traumatic brain injury (TBI) can induce cell damage. Procoagulant microparticles (MPs) are reliable markers of cell stimulation. The aim of this study was to investigate the generation of procoagulant MPs in the cerebrospinal fluid (CSF) and plasma of patients with severe TBI.Material: CSF and plasma MPs of 16 patients with severe TBI were quantified by functional prothrombinase assay (i) on the day of the trauma, (ii) during a 10-day follow-up and compared with control samples. The cellular origin of NIP was determined after capture with specific antibodies.Results: The CSF and plasma of patients with severe TBI revealed a significantly increased generation of MP compared with control samples on the day of the trauma (CSF: 4.5 +/- 1.8 vs. 0.83 +/- 0.28 nanomolar PhtdSer equivalent; p = 0.01 and plasma 4.1 +/- 3.7 vs. 2.3 +/- 0.19 nanomolar PhtdSer equivalent; p = 0.02). Procoagulant MPs were mainly of platelet and endothelial origin in CSF. MPs decreased significantly in the CSF 10 days after TBI. In CSF, a sustained generation of procoagulant MP was evidenced in two patients presenting a poor clinical outcome. In the blood flow, elevated amounts of procoagulant MEN were detected in three patients presenting disseminated intravascular coagulopathy during the follow-up.Conclusion: Procoagulant MP testifying to platelet and endothelial activation are produced in the CSF and in the plasma after severe TBI. A sustained generation of procoagulant MP in the CSF could contribute to a poor clinical outcome.