Table_2_The Connection Between Selected Caspases Levels in Bronchoalveolar Lavage Fluid and Severity After Brain Injury.DOCX

ObjectiveThe interaction between the brain and lungs has been the subject of many clinical reports, while the exact impact of brain injury on the physiology of the respiratory system is still subject to numerous experimental studies. The purpose of this study was to investigate the activation of selected caspases levels in bronchoalveolar lavage fluid (mini BALF) of patients after isolated brain injury and their correlation with the severity of the injury.MethodsThe analysis was performed on patients who were admitted to the intensive care unit (ICU) for severe isolated brain injury from March 2018 to April 2020. All patients were intubated and mechanically ventilated. Mini BALF was collected within the first 6–8 h after trauma and on days 3 and 7 after admission. The concentrations of selected caspases were determined and correlated with the severity of brain injury evaluated by the Rotterdam CT Score, Glasgow Coma Score, and 28-day mortality.ResultsOur results showed significantly elevated levels of selected caspases on days 3 and 7 after brain injury, and revealed apoptosis activation during the first 7 days after brain trauma. We found a significant different correlation between the elevation of selected caspases 3, 6, 8, and 9, and the Glasgow Coma Score, Rotterdam CT scale, and 28-day mortality.ConclusionsThe increased levels of selected caspases in the mini BALF in our patients indicate an intensified activation of apoptosis in the lungs, which is related to brain injury itself via various apoptotic pathways and correlates with the severity of brain injury.

本研究旨在探究孤立性脑损伤后患者支气管肺泡灌洗液（微型BALF）中选定caspase水平的激活情况，及其与损伤严重程度的相关性。研究方法针对2018年3月至2020年4月期间入住重症监护室（ICU）的严重孤立性脑损伤患者进行。所有患者均接受气管插管和机械通气。在创伤后的前6至8小时内以及入院后的第3天和第7天收集微型BALF。测定选定caspase的浓度，并将其与通过阿姆斯特丹CT评分、格拉斯哥昏迷评分以及28天死亡率评估的脑损伤严重程度相关联。研究结果揭示了脑损伤后第3天和第7天选定caspase水平显著升高，并在脑创伤后的前7天内发现了细胞凋亡激活。我们发现选定caspase 3、6、8和9的升高与格拉斯哥昏迷评分、阿姆斯特丹CT评分和28天死亡率之间存在显著的相关性。结论表明，患者微型BALF中选定caspase水平的升高，表明肺中细胞凋亡的激活加剧，这与脑损伤本身通过多种细胞凋亡途径相关联，并且与脑损伤的严重程度相关。