• Hada Macher, Juan J Egea-Guerrero, Jaume Revuelto-Rey, Elena Gordillo-Escobar, Judy Enamorado-Enamorado, Antonio Boza, Ana Rodriguez, Patrocinio Molinero, Juan M Guerrero, José Maria Dominguez-Roldán, Francisco Murillo-Cabezas, and Amalia Rubio.
• Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Spain. hadamacher@hotmail.com
• Clin. Chim. Acta. 2012 Dec 24;414:12-7.

IntroductionCirculating cell-free DNA levels are increased after trauma injury. This increase is higher since the first hours after trauma and may be related with primary outcome. A sensitive and reliable biomarker for patients at higher risk is needed to identify these patients to initiate early intervention. In this way, circulating DNA may be a possible biological marker after severe TBI.Materials And MethodsWe investigated DNA plasma concentrations after severe traumatic brain injury and during the next 96 h in the Intensive Care Unit (ICU) by real time PCR. 65 patients suffering severe TBI were included in the study.ResultsCell-free DNA levels were considerably higher in patients samples compared with voluntary control ones. After the following four days we observed a 51% decrease during the first 24h and a 71% fall from 48 h. TBI population was stratified for the primary outcome (survivors/non-survivor) and DNA levels decrease ratio was calculated for the first 48 h. A higher decrease in the survivors from 0 h to 24h compared with the non-survivors was found. A cut-off point of 1.95 ratio was established for the detection of the highest proportions of patients after the TBI that will not survive after the injury with a sensitivity of 70% and specificity of 66%.ConclusionsIn summary we showed that severe TBI is associated with elevated cf-DNA levels and we propose that cf-DNA decrease during the first 24h may predict patient outcome.Copyright © 2012 Elsevier B.V. All rights reserved.

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