Zhang Yuanda, Zhang Qiao, Sun Lihua, Zhao Dongxu, Ruan Cijie, Zhou Jue, Tan Haoyuan, Bao Yinghui
Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China.
Shanghai Key Laboratory for Tumor Microenvironment and Inflammation, Department of Biochemistry and Molecular Cell Biology, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
J Clin Med. 2022 Jun 27;11(13):3700. doi: 10.3390/jcm11133700.
Traumatic brain injury (TBI) is a common neurological disease. Netrin-1 and deleted in colorectal cancer (DCC) receptor are potential biomarkers associated with nerve regeneration and immune regulation. We aimed to investigate the ability of the DCC receptor and Netrin-1 to predict a high ICP level after operation in severe traumatic brain injury and their prognostic significance. This study is a prospective observational study. We selected 23 patients with traumatic brain injury who had undergone surgical operations as subjects. Immunohistochemical staining was performed on the contusion tissue that was removed by the operation to determine the expression of DCC receptor. At the same time, enzyme-linked immunosorbent assay (ELISA) kits were used to detect the serum Netrin-1 content. Determination of intracranial pressure (ICP) value was measured by intraventricular catheter. The Glasgow Outcome Scale (GOS) score at six months after trauma was defined as the main study endpoint. The results showed that serum Netrin-1 concentrations of patients in the critical TBI group (GCS 3-5 points) was significantly lower than that in the severe TBI group (GCS 6-8 points). The ICP peak and average mannitol consumption in the high Netrin-1 group were significantly lower than those in the low Netrin-1 group. DCC receptor-positive patients had a significantly lower ICP peak. There was no significant difference in six month-GOS scores between patients in the high and low Netrin-1 groups, while DCC receptor concentrations below 3.82 ng/mL predicted poor prognosis (GOS 1-3 points). In conclusion, the expression level of the DCC receptor can better evaluate the postoperative high ICP level and prognosis than the level of serum Netrin-1 in severe traumatic brain injury.
创伤性脑损伤（TBI）是一种常见的神经系统疾病。Netrin-1和结直肠癌缺失（DCC）受体是与神经再生和免疫调节相关的潜在生物标志物。我们旨在研究DCC受体和Netrin-1预测重度创伤性脑损伤术后高颅内压水平的能力及其预后意义。本研究是一项前瞻性观察性研究。我们选择23例接受过手术的创伤性脑损伤患者作为研究对象。对手术切除的挫伤组织进行免疫组织化学染色，以确定DCC受体的表达。同时，使用酶联免疫吸附测定（ELISA）试剂盒检测血清Netrin-1含量。通过脑室内导管测量颅内压（ICP）值。将创伤后6个月的格拉斯哥预后量表（GOS）评分定义为主要研究终点。结果显示，重度TBI组（GCS 3 - 5分）患者的血清Netrin-1浓度显著低于重度TBI组（GCS 6 - 8分）。高Netrin-1组的ICP峰值和甘露醇平均消耗量显著低于低Netrin-1组。DCC受体阳性患者的ICP峰值显著较低。高Netrin-1组和低Netrin-1组患者的6个月GOS评分无显著差异，而DCC受体浓度低于3.82 ng/mL预测预后不良（GOS 1 - 3分）。总之，在重度创伤性脑损伤中，DCC受体的表达水平比血清Netrin-1水平能更好地评估术后高ICP水平和预后。
