GFAP and NF expression in brain tissue in children and adults after fatal traumatic brain injury
Keywords: severe traumatic brain injury, secondary brain injury, structural brain damage, reactive astrocytes, glial fibrillary acidic protein, neurofilament, astrogliosis
AbstractBackground and objectives. Still, there is almost no information about the role of biomarkers in the pathological processes of the brain in those patients, which die immediately after the injury, and those, which die several hours after the trauma. Design and Settings. A retrospective study. The human brain tissue material from the archive of the Institute of Anatomy and Anthropology in Riga Stradins University (RSU). Methods. We used the brain tissue material from the trauma and counterstroke spots of 28 patients. Brain tissue specimens were routinely fixed, embedded into paraffin, cut in 5 μm thick slides. For immunohistochemistry we used monoclonal antibodies against NF proteins to detect axonal injury and monoclonal antibodies against GFAP to detect astrocytes. Results. Statistical correlation was seen between the lethal cases and survived in the brain tissue in the areas of counterstroke between lethal cases and survived for NF and GFAP presence (p=0.017). The data was compared, by dividing patients into groups of children and adults. Each of these groups was divided into 2 sub-groups. Statistically significant differences were noted between the lethal and the survived cases in the group of children for GFAP (Mann-Whitney U Test, p=0.015) and in the group of adults for NF in the area of the counterstroke (Mann-Whitney U Test, p=0.019). Conclusions. Higher quantities of intermediated filaments such as GFAP and NF are characteristic in the patients who survived after a head trauma in comparison to those, who died on the spot of the accident. Children under 2 years of age with severe head trauma have more dynamic glial cell reaction than other patients.