Downregulation of MMP-9 Level and GCS Score Improvement in Severe Traumatic Brain Injury Due to the Mild Hypothermia Therapy

Abstract

We recently investigated the effect of the mild hypothermia therapy towards alteration of matrix metalloproteinase-9 (MMP-9) and outcome of severe traumatic brain injury (TBI). The neurologic outcome was assessed by applying with GCS (Glasgow Coma Scale) score. Twenty patients with severe TBI whose the GCS score ≤ 8 between June 2015 and June 2016 were enrolled in RD Kandou Hospital, Manado, Indonesia. Patients were randomized into two groups, with and without the mild hypothermia therapy (34-36°C) which was investigated within 24 and 72 h. The MMP-9 level was estimated using enzyme-linked immunosorbent assay (ELISA). The assessments of outcomes were determined using the GCS score within 24 and 72 h during the mild hypothermia therapy. Our results showed that the level of serum MMP-9 was decreased significantly within 72 h in the mild hypothermia therapy group. The effects of the mild hypothermia therapy toward to the GCS score alteration were noticeable increased and differences were significant in the two groups within 72 h. We concluded that the mild hypothermia therapy diminished MMP-9 protein level and improvement of the GCS score in severe TBI patients within 72 h.