Abstract
To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cell-derived factor-1α (SDF-1α)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. 72 TBI patients (57 mild TBI, 15 moderate TBI patients) and 25 healthy subjects (control) were included. The number of circulating EPCs, CD34+, and CD133+ cells and the percentage of CXCR4+ cells in each cell population at 1,4,7,14,21 days after TBI were counted by flow cytometer. SDF-1α levels in serum were detected by ELISA assay. The patients were divided into poor and good prognosis groups based on Extended Glasgow Outcome Scale and Activity of Daily Living Scale at 3 months after TBI. Correlation analysis between each detected index and prognosis of mild TBI was performed. Moderate TBI patients have higher levels of SDF-1α and CXCR4 expression than mild TBI patients (P < 0.05). The percentage of CXCR4+ EPCs at day 7 post-TBI was significantly higher in mild TBI patients with poor prognosis than the ones with good prognosis (P < 0.05). HAMA and HAMD scores in mild TBI patients were significantly lower than moderate TBI patients (P < 0.05) in early term. The percentage of CXCR4+ EPCs at day 7 after TBI was significantly correlated with the prognosis outcome at 3 months. The mobilization of circulating EPCs can be induced in mild TBI. The expression of CXCR4+ in EPCs at 7 days after TBI reflects the short-term prognosis of brain injury, and could be a potential biological marker for prognosis prediction of mild TBI.
Highlights
To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cellderived factor-1α (SDF-1α)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. 72 TBI patients (57 mild TBI, 15 moderate TBI patients) and 25 healthy subjects were included
It is hypothesized that (1) characteristic changes of peripheral blood EPCs exist in mild TBI patients; (2) peripheral blood SDF1α and the CXCR4 expression in different cell populations might be related to the prognosis of mild TBI patients
Applying the Glasgow Outcome Scale (GOS-E) and Activity of Daily Living Scale (ADLS) at 3 months post-TBI, the 57 mild TBI patients could be subgrouped into good prognosis and poor prognosis groups
Summary
To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cellderived factor-1α (SDF-1α)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. 72 TBI patients (57 mild TBI, 15 moderate TBI patients) and 25 healthy subjects (control) were included. To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cellderived factor-1α (SDF-1α)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. Moderate TBI patients have higher levels of SDF-1α and CXCR4 expression than mild TBI patients (P < 0.05). Our previous study further confirmed that EPCs were rapidly mobilized from the bone marrow into the blood after TBI, and recruited to sites of injury, where they promoted neovascularization, or directly proliferated and differentiated into endothelial cells to form vessels, participate in tissue repair and thereby improve neural functional outcome [12]. Li et al [20] have demonstrated that SDF-1α mobilizes CD34+/CXCR4+ cells to the sites of injury after TBI, which promotes neovascularization in the traumatic region and benefits for post-traumatic brain tissue repair and functional reconstruction. It is hypothesized that (1) characteristic changes of peripheral blood EPCs exist in mild TBI patients; (2) peripheral blood SDF1α and the CXCR4 expression in different cell populations might be related to the prognosis of mild TBI patients
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