Abstract
PurposeThe aim of the study is to characterize changes in circulating proteasome (c-proteasome) activity following mild traumatic brain injury in children.MethodsFifty children managed at the Department of Pediatric Surgery because of concussion—mild head injury was randomly included into the study. The children were aged 11 months to 17 years (median = 10.07 + −1.91 years). Plasma proteasome activity was assessed using Suc-Leu-Leu-Val-Tyr-AMC peptide substrate, 2–6 h, 12–16 h, and 2 days after injury. Twenty healthy children admitted for planned inguinal hernia repair served as controls.ResultsStatistically significant elevation of plasma c-proteasome activity was noted in children with mild head injury 2–6 h, 12–16 h, and 2 days after the injury.ConclusionsAuthors observed a statistically significant upward trend in the c-proteasome activity between 2–6 and 12–16 h after the mild head injury, consistent with the onset of the symptoms of cerebral concussion and a downward trend in the c-proteasome activity in the plasma of children with mild head injury between 12–16 h and on the second day after the injury, consistent with the resolving of the symptoms of cerebral concussion. Further studies are needed to demonstrate that the proteasome activity could be a prognostic factor, which can help in further diagnostic and therapeutic decisions in patients with head injury.
Highlights
The 20S proteasome chymotrypsin-like protease activity (ChT-L) activity was calculated from the differences between the fluorescence in the sample incubated with the substrate and the sample incubated with 0.1 % dimethyl sulfoxide (DMSO)
In the group of our patients with mild head injury, the cproteasome activity 2–6 h after the injury, 12–16 h after injury, and 2 days after injury were above the range of activity measured in controls which was statistically significant (Fig. 1)
There was an upward trend in the c-proteasome activity between 2–6 and 12–16 h after the injury, consistent with the onset of the symptoms of cerebral concussion and a downward trend in the c-proteasome activity in the plasma of children with mild TBI between 12–16 h and on the second day after the injury, consistent with the resolving of the symptoms of cerebral concussion
Summary
Most children with head trauma are young, male, and have a mild injury [31]. Mild head injury is generally associated with symptoms such as a brief loss of consciousness, disorientation, or vomiting. Patients with mild head injury usually have GCS scores of 13 to 15, measured approximately 30 min after the injury [30, 31]. The onset of impairment is rapid, but usually short-lived, and generally resolves spontaneously. Head injury is the most common cause of death and disability during childhood [19, 30, 31]
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