Critical Care

, 1:P010 | Cite as

Selectins in multiple injured patients with severe head trauma

  • T Kerner
  • S Höfler
  • D Keh
  • S Spielmann
  • M Gerlach
  • K Falke
  • HP Adams
  • H Gerlach
Meeting abstract
  • 2.1k Downloads

Keywords

Head Injury Head Trauma Injury Severity Score Severe Head Injury Severe Head Trauma 

High mortality rates days or weeks after multiple injury are often due to multiple organ dysfunction (MODS). Recent studies put a close view to the course of immunological mediators as the members of the selectin family to figure out their contribution to shock, sepsis and organ failure [1]. Brain contusion is supposed to cause cellular infiltrates and inflammation in brain tissue [2].

P-selectin (CD62P) is stored in endothelial cells (EC) Wiebel-Palade-bodies and in thrombocytes. It is rapidly released after cell activation. E-selectin (CD62E) is expressed on the cell surface of EC and shed from there after IL-1/TNF stimulation. L-selectin (CD62L) can be found on the surface of leukocytes. Cell activation leads to shed L-selectin by proteolytic processes [3].

We examined soluble E- and P-selectin and L-selectin on B-lymphocytes in multiple injured patients without or with moderate or with severe head injury. The classification of head injury was performed following the injury severity score (ISS) (0-2 pts, moderate; 3-5 pts, severe head injury).

sE-, P- and L-selectin were- measured in 51 multiple injured patients with samples taken on 10 time points (from the location of the accident = 0 h to the 6th post-traumatic day = 144 h) by using commercially available standardized enzyme-linked immunoassays (ELISA). CD62L levels on leukocyte subpopulations were detected using the monoclonal antibodies CD62L (LECAM-1), CD3 (T-cell), CD19 (B-cell), CD14 (monocyte) and a standard flow cytometer.

Table 1 demonstrates the very early increase of sP-selectin in patients with severe head injury (P = 0.0001) compared to those with moderate or no head injury.

Table 2 illustrates the later increase (P = 0.0026) of sL-selectin levels (72 h) in severe head injured individuals while L-selectin on CD19+ B-lymphocytes is expressed significantly stronger (P = 0.0001) in the very early post-traumatic phase (0-24 h) = Table 3.

The gravity of head trauma seems to influence the immunological response and subsequently the cell-cell interactions.

Table 1

Table 2

Table 3

Notes

Acknowledgement

Supported by the BMVg, Grant InSan 1 0993-V-1296.

References

  1. 1.
    Gearing AH, Newman W: Circulating adhesion molecules in disease. Immunology Today. 1993, 14: 506-512. 10.1016/0167-5699(93)90267-O.PubMedCrossRefGoogle Scholar
  2. 2.
    Holmin S, Mathiesen T, Shetye J, Biberfeld P: Intracerebral inflammatory response to experimental brain contusion. Acta Neurochirurgica. 1995, 132: 110-119. 10.1007/BF01404857.PubMedCrossRefGoogle Scholar
  3. 3.
    Redl H, Nikolai A, Kneidinger R, Schlag G: Endothelial and leukocyte activation in experimental polytrauma and sepsis. Behring Inst Mitt. 1993, 92: 218-228.PubMedGoogle Scholar

Copyright information

© Current Science Ltd 1997

Authors and Affiliations

  • T Kerner
    • 1
  • S Höfler
    • 1
  • D Keh
    • 1
  • S Spielmann
    • 1
  • M Gerlach
    • 1
  • K Falke
    • 1
  • HP Adams
    • 1
  • H Gerlach
    • 1
  1. 1.Clinic of Anesthesiology and Intensive Care Medicine, Virchow-KlinikumHumboldt University of BerlinGermany

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