Abstract
BackgroundInflammation is considered a hallmark of concussion pathophysiology in experimental models, yet is understudied in human injury. Despite the growing use of blood biomarkers in concussion, inflammatory biomarkers have not been well characterized. Furthermore, it is unclear if the systemic inflammatory response to concussion differs from that of musculoskeletal injury. The purpose of this paper was to characterize systemic inflammation after injury in athletes with sport-related concussion or musculoskeletal injury.MethodsA prospective, observational cohort study was conducted employing 175 interuniversity athletes (sport-related concussion, n = 43; musculoskeletal injury, n = 30; healthy, n = 102) from 12 sports at a sports medicine clinic at an academic institution.High-sensitivity immunoassay was used to evaluate 20 inflammatory biomarkers in the peripheral blood of athletes within 7 days of injury (subacute) and at medical clearance. Healthy athletes were sampled prior to the start of their competitive season. Partial least squares regression analyses were used to identify salient biomarker contributions to class separation between injured and healthy athletes, as well as to evaluate the relationship between biomarkers and days to recovery in injured athletes.ResultsIn the subacute period after injury, compared to healthy athletes, athletes with sport-related concussion had higher levels of the chemokines’ monocyte chemoattractant protein-4 (p < 0.001) and macrophage inflammatory protein-1β (p = 0.001); athletes with musculoskeletal injury had higher levels of thymus and activation-regulated chemokine (p = 0.001). No significant differences in biomarker profiles were observed at medical clearance. Furthermore, concentrations of monocyte chemoattractant protein-1 (p = 0.007) and monocyte chemoattractant protein-4 (p < 0.001) at the subacute time point were positively correlated with days to recovery in athletes with sport-related concussion, while thymus and activation-regulated chemokine was (p = 0.001) positively correlated with days to recovery in athletes with musculoskeletal injury.ConclusionSport-related concussion is associated with perturbations to systemic inflammatory chemokines that differ from those observed in athletes with a musculoskeletal injury. These results support inflammation as an important facet of secondary injury after sport-related concussion that can be measured systemically in a human model of injury.
Highlights
Sport-related concussion (SRC) is a traumatic brain injury (TBI) induced by biomechanical forces
At the time of blood sampling, athletes with SRC reported a median total symptom score of 9.5 and a median symptom severity of 16; both were significantly higher than athletes with MSK injury and healthy athletes
We have previously found that elevated levels of monocyte chemoattractant protein (MCP)-1 in the acute period (< 24 h) after moderate-to-severe TBI are correlated with adverse outcomes and mortality [43]
Summary
Sport-related concussion (SRC) is a traumatic brain injury (TBI) induced by biomechanical forces It is considered a mild form of TBI since no abnormalities are identified on standard structural neuroimaging [1]. Studies employing advanced neuroimaging and fluid biomarkers have enhanced our knowledge of the mechanistic underpinnings of SRC in humans These investigations have yielded evidence to support acute and subacute structural and functional alterations in the brain, including changes to functional connectivity [6,7,8] and cerebral blood flow [7, 9], axonal/neuronal injury [10,11,12,13], oxidative damage/stress [14], and inflammation [7, 15, 16]. The purpose of this paper was to characterize systemic inflammation after injury in athletes with sport-related concussion or musculoskeletal injury
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
