Changes of NLRP3 in serum and cerebrospinal fluid of patients after moderate to severe traumatic brain injury and their predictive values for prognosis

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2024-09-20 DOI:10.1111/cns.70009

Wei Chen, Zhigang Wang, Gengfan Ye, Guangyao Zhu, Shiwei Li, Pandi Chen, Hongcai Wang, Shufeng Zou, Maosong Chen

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Abstract

Background

Traumatic brain injury (TBI) remains a major concern for global health. Recent studies have suggested the role of NOD-like receptor pyrin domain-containing protein 3 (NLRP3), an inflammatory marker, in the cerebrospinal fluid (CSF) and serum as potential indicators of TBI prognosis. The objective of the study was to characterize NLRP3 as a clinically applicable tool for predicting the outcomes of TBI patients.

Methods

A total of 270 patients with moderate to severe TBI were included in this retrospective analysis. Serum and CSF samples were collected at 1-, 3-, 7-, and 21-day post-injury to measure NLRP3 levels. The prognosis of patients was evaluated after 3 months using the Glasgow Outcome Scale (GOS). Patients were categorized into good prognosis (GOS score >3) and poor prognosis (GOS score ≤3) groups. The relationship between NLRP3 levels and prognosis was analyzed.

Results

Patients with poor prognosis had significantly elevated NLRP3 levels in their serum on days 1 and 3 post-injury compared with those with a good prognosis. The difference was more pronounced during these early days compared with days 7 and 21. However, NLRP3 levels in CSF consistently showed a large difference between the two groups throughout the observation period. Receiver operating characteristic analysis revealed that the level of NLRP3 in the CSF on day 3 post-injury had the highest predictive value for prognosis, with an area under the curve of 0.83, followed by the level of NLRP3 in the serum on day 3 post-injury.

Conclusions

The levels of NLRP3, especially in the CSF on day 3 post-injury, can serve as a potential biomarker for predicting prognosis in moderate to severe TBI patients. Early measurement of NLRP3 levels can provide valuable insights into patient outcomes and guide therapeutic strategies.

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中重度脑外伤后患者血清和脑脊液中 NLRP3 的变化及其对预后的预测价值

背景创伤性脑损伤（TBI）仍然是全球健康的一个主要问题。最近的研究表明，脑脊液（CSF）和血清中的炎症标志物 NOD 样受体 pyrin 结构域含蛋白 3（NLRP3）可作为创伤性脑损伤预后的潜在指标。本研究的目的是确定 NLRP3 的特征，将其作为预测创伤性脑损伤患者预后的临床适用工具。方法本次回顾性分析共纳入了 270 名中度至重度创伤性脑损伤患者。在伤后 1、3、7 和 21 天采集血清和脑脊液样本，测量 NLRP3 水平。3 个月后，使用格拉斯哥结果量表（GOS）对患者的预后进行评估。患者被分为预后良好组（GOS评分>3）和预后不良组（GOS评分≤3）。分析了 NLRP3 水平与预后之间的关系。结果与预后良好的患者相比，预后不良的患者在伤后第 1 天和第 3 天血清中的 NLRP3 水平明显升高。与第 7 天和第 21 天相比，早期患者血清中的 NLRP3 水平差异更为明显。然而，在整个观察期间，两组患者脑脊液中的 NLRP3 水平始终存在较大差异。接收器操作特征分析显示，伤后第 3 天 CSF 中的 NLRP3 水平对预后的预测价值最高，曲线下面积为 0.83，其次是伤后第 3 天血清中的 NLRP3 水平。结论 NLRP3水平，尤其是伤后第3天脑脊液中的NLRP3水平，可作为预测中重度创伤性脑损伤患者预后的潜在生物标志物。早期测量 NLRP3 水平可为了解患者预后和指导治疗策略提供有价值的信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.