Citation

Osthoff M, Walder B, Delhumeau C, Trendelenburg M, Turck N. J. Neurotrauma 2017; 34(17): 2560-2566.

Affiliation

Geneva University, Human Protein Sciences , Centre Medical Universitaire , Rue Michel Servet, 1 , Geneva, Switzerland , CH-1211 ; natacha.turck@unige.ch.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4941

PMID

28482760

Abstract

The lectin pathway of the complement system has been implicated in secondary ischemic/inflammatory injury after traumatic brain injury (TBI). However, previous experimental studies have yielded conflicting results, and human studies are scarce. In this exploratory study we investigated associations of several lectin pathway proteins early after injury and single-nucleotide polymorphisms (SNP) with outcomes after severe TBI [mortality at 14 days (primary outcome) and consciousness assessed with the Glasgow Coma Scale (GCS) at 14 days, disability assessed with the Glasgow Outcome Scale Extended (GOSE) at 90 days]. 44 patients with severe TBI were included. Plasma levels of lectin pathway proteins sampled at 6, 12, 24 and 48 hours after injury and eight MBL2 and FCN2 SNPs were analysed by ELISA and genotyping, respectively. Plasma protein levels were stable with only a slight increase in MASP-2 and ficolin-2 levels after 48 hours (p<0.05), respectively. Neither lectin protein plasma levels (6h or mean levels) nor MBL2 genotypes or FCN2 variant alleles were associated with 14-day mortality or 14-day consciousness. However, Ficolin-2, -3 and MASP-2 levels were higher in patients with an unfavourable outcome (GOSE 1-4) at 90 days (p<0.05), whereas there was no difference in MBL2 genotypes or FCN2 variant alleles. In particular, higher mean MASP-2 levels over 48 hours were independently associated with a GOSE score <4 at 90 days after adjustment (Odds ratio 3.46 (95% confidence interval 1.12-10.68) per 100 ng/ml increase, p=0.03). No association was observed between the lectin pathway of the complement system and 14-day mortality or 14-day consciousness. However, higher plasma ficolin-2, -3 and in particular MASP-2 levels early after injury were associated with an unfavourable outcome at 90 days (death, vegetative state and severe disability) which may be related to an increased activation of the lectin pathway.

Language: en

Keywords

HUMAN STUDIES; INFLAMMATION; ISCHEMIA; PROSPECTIVE STUDY; TRAUMATIC BRAIN INJURY