Lin Yunpeng, Luo Lan Lan, Sun Jian, Gao Weiwei, Tian Ye, Park Eugene, Baker Andrew, Chen Jieli, Jiang Rongcai, Zhang Jianning
1Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-neurotrauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin 300052, China.
2Department off Psychological Science, Tianjin Medical University General Hospital, Tianjin 300052, China.
Aging Dis. 2017 Feb 1;8(1):115-127. doi: 10.14336/AD.2016.0610. eCollection 2017 Feb.
To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cell-derived factor-1α (SDF-1α)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. 72 TBI patients (57 mild TBI, 15 moderate TBI patients) and 25 healthy subjects (control) were included. The number of circulating EPCs, CD34, and CD133 cells and the percentage of CXCR4 cells in each cell population at 1,4,7,14,21 days after TBI were counted by flow cytometer. SDF-1α levels in serum were detected by ELISA assay. The patients were divided into poor and good prognosis groups based on Extended Glasgow Outcome Scale and Activity of Daily Living Scale at 3 months after TBI. Correlation analysis between each detected index and prognosis of mild TBI was performed. Moderate TBI patients have higher levels of SDF-1α and CXCR4 expression than mild TBI patients (P < 0.05). The percentage of CXCR4 EPCs at day 7 post-TBI was significantly higher in mild TBI patients with poor prognosis than the ones with good prognosis (P < 0.05). HAMA and HAMD scores in mild TBI patients were significantly lower than moderate TBI patients (P < 0.05) in early term. The percentage of CXCR4 EPCs at day 7 after TBI was significantly correlated with the prognosis outcome at 3 months. The mobilization of circulating EPCs can be induced in mild TBI. The expression of CXCR4 in EPCs at 7 days after TBI reflects the short-term prognosis of brain injury, and could be a potential biological marker for prognosis prediction of mild TBI.
探讨轻度创伤性脑损伤（TBI）患者循环内皮祖细胞（EPCs）及基质细胞衍生因子-1α（SDF-1α）/CXCR4表达的变化，以及EPC水平与轻度TBI预后的相关性。纳入72例TBI患者（57例轻度TBI，15例中度TBI患者）和25例健康受试者（对照组）。采用流式细胞仪计数TBI后1、4、7、14、21天循环EPCs、CD34和CD133细胞数量以及各细胞群中CXCR4细胞的百分比。采用酶联免疫吸附测定法检测血清中SDF-1α水平。根据TBI后3个月的扩展格拉斯哥预后量表和日常生活活动量表将患者分为预后不良组和预后良好组。对各检测指标与轻度TBI预后进行相关性分析。中度TBI患者的SDF-1α和CXCR4表达水平高于轻度TBI患者（P<0.05）。预后不良的轻度TBI患者TBI后第7天CXCR4⁺EPCs百分比显著高于预后良好的患者（P<0.05）。早期轻度TBI患者的汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分显著低于中度TBI患者（P<0.05）。TBI后第7天CXCR4⁺EPCs百分比与3个月时的预后结果显著相关。轻度TBI可诱导循环EPCs的动员。TBI后7天EPCs中CXCR4的表达反映脑损伤的短期预后，可能是预测轻度TBI预后的潜在生物学标志物。
