Department of Neurosurgery, Faculty of Medicine, Masaryk University and University Hospital, Brno, Czech Republic.
Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Neurol Sci. 2023 Mar;44(3):1031-1038. doi: 10.1007/s10072-022-06482-1. Epub 2022 Nov 10.
Brain injuries are the most common cause of death in productive age. Besides the extent of the injury, other systemic factors can also affect the outcome. Patients suffering from severe brain injury often experience extracranial inflammatory complications during the early period of treatment. Here, we investigate the changes in immunity in patients with brain injury.
121 patients and 92 healthy controls were included in the research. Blood samples were collected on admission and analyzed by flow cytometry and biochemical methods. Multiple clusters of differentiation (CD) and antibody levels were investigated. The results were compared between patients and controls. In addition, results of two classes of severity (Glasgow Coma Scale, GCS, of 3-5 vs. 6-8) were also compared.
Parameters of humoral immunity in patients immediately after admission were significantly lower than those from healthy donors, with the exception of IgE elevated as much as to resemble allergic reaction (p < 0.01). Of cellular parameters, only natural killer (NK) cluster CD56 + was elevated (p < 0.01). Extracranial infectious complications were more common in patients with GCS 3-5.
Strong immune system disorders were observed in patients after severe brain injury, which may contribute to the worse outcome in such patients.
脑损伤是生产年龄人群中最常见的死亡原因。除了损伤程度外,其他全身因素也会影响结果。患有严重脑损伤的患者在治疗早期经常会出现颅外炎症并发症。在这里,我们研究了脑损伤患者的免疫变化。
研究纳入了 121 名患者和 92 名健康对照者。入院时采集血样,采用流式细胞术和生化方法进行分析。研究了多个分化群(CD)和抗体水平。将患者和对照组的结果进行比较。此外,还比较了两个严重程度类别(格拉斯哥昏迷量表,GCS,3-5 与 6-8)的结果。
患者入院后即刻的体液免疫参数明显低于健康供体,除了 IgE 升高到类似过敏反应的程度(p<0.01)。细胞参数中,只有自然杀伤(NK)簇 CD56+升高(p<0.01)。GCS 为 3-5 的患者更容易发生颅外感染并发症。
严重脑损伤后患者的免疫系统明显紊乱,这可能导致此类患者的预后更差。