Hassan Samah Abdelrahman, Gassoum Alsadig, Aldeaf Sawsan Ahmed Hamed, Arbab Mohamed Abdel Rahman, Musa Hassan Hussein
Alneelain University Department of Immunology, Faculty of Medical Laboratory Sciences Khartoum Sudan.
Almugtaribeen University Department of Medical Microbiology, Faculty of Medicine Khartoum Sudan.
J Acute Med. 2020 Mar 1;10(1):1-8. doi: 10.6705/j.jacme.202003_10(1).0001.
Acute inflammation in the brain after trauma is mediated by acute inflammatory cells (neutrophils) that contributes to ischemic brain damage, neurological deterioration, and poor outcome. Migration of neutrophils to brain is mediated by intercellular adhesion molecule-1 (ICAM-1). The aim was to determine an association between neutrophils counts, ICAM-1 level and mutation in ICAM-1 gene with injury severity and patient's outcome.
Cross-sectional study was conducted for ninety Sudanese patients presented with traumatic cerebral hemorrhagic contusion to the National Center for Neurological Sciences, Khartoum, Sudan from December 2015 to January 2018. Non-Sudanese patients, and hemorrhagic contusion associated with other type of brain bleeding were excluded in this study. Moreover, 90 apparently healthy individuals were participated as control
Most patients were males (93.3%), their ages ranged from 25 to 44 years, 11.1% of the patients had severe brain injury, 22.2% had brain edema and the mortality rate was 8.9%. Circulatory levels of leukocytes, neutrophil and ICAM-1 among patients who sustained trauma were significantly elevated compared with controls ( = 0.000). The high level of leukocytes and neutrophils counts were significantly associated with ICAM-1pg/mL circulatory level. High levels of leukocytes, neutrophils, and ICAM-1 were documented in severe brain injuries, whereas. high level of ICAM-1 was observed among patients admitted with brain edema. Leukocytes and neutrophils counts were significantly associated with patient outcome. High level of ICAM-1 (304.88 pg/mL) was observed among patients with poor outcome compared to survivals (263.93 pg/mL). The highest circulatory level of ICAM-1 (280.75 pg/mL) was observed among patient having adenine-adenine (AA) mutant homozygous alleles, followed by (272 pg/mL) for guanine-guanine (GG) homozygous alleles, then (245.12 pg/mL) for guanine-adenine (GA) heterozygous alleles.
Mutation in ICAM-1 gene and increased levels of leukocytes, neutrophils and ICAM-1 constitutes important markers for injury severity and patient's outcome.
创伤后脑内的急性炎症由急性炎症细胞（中性粒细胞）介导，这会导致缺血性脑损伤、神经功能恶化及不良预后。中性粒细胞向脑内的迁移由细胞间黏附分子-1（ICAM-1）介导。本研究旨在确定中性粒细胞计数、ICAM-1水平及ICAM-1基因突变与损伤严重程度和患者预后之间的关联。
对2015年12月至2018年1月期间就诊于苏丹喀土穆国家神经科学中心的90例创伤性脑内出血性挫伤的苏丹患者进行了横断面研究。本研究排除了非苏丹患者以及合并其他类型脑出血的出血性挫伤患者。此外，90名明显健康的个体作为对照参与研究。
大多数患者为男性（93.3%），年龄在25至44岁之间，11.1%的患者有严重脑损伤，22.2%的患者有脑水肿，死亡率为8.9%。与对照组相比，创伤患者的白细胞、中性粒细胞和ICAM-1的循环水平显著升高（P = 0.000）。白细胞和中性粒细胞计数的高水平与ICAM-1的循环水平显著相关。在严重脑损伤患者中记录到白细胞、中性粒细胞和ICAM-1的高水平，而在脑水肿患者中观察到ICAM-1的高水平。白细胞和中性粒细胞计数与患者预后显著相关。与存活患者（263.93 pg/mL）相比，预后不良患者中观察到较高水平的ICAM-1（304.88 pg/mL）。在具有腺嘌呤-腺嘌呤（AA）突变纯合等位基因的患者中观察到ICAM-1的最高循环水平（280.75 pg/mL），其次是鸟嘌呤-鸟嘌呤（GG）纯合等位基因的患者（272 pg/mL），然后是鸟嘌呤-腺嘌呤（GA）杂合等位基因的患者（245.12 pg/mL）。
ICAM-1基因突变以及白细胞、中性粒细胞和ICAM-1水平的升高是损伤严重程度和患者预后的重要标志物。
