Clinical Research

Heme Oxygenase 1 in Cerebrospinal Fluid from Infants and Children after Severe Traumatic Brain Injury
J'mir L. Cousar^a, Yichen Lai^{a, d}, Christina D. Marco^a, Hülya Bayr^{a, d}, P. David Adelson^{b, d}, Keri L. Janesko-Feldman^a, Patrick M. Kochanek^{a, c, d}, Robert S.B. Clark^{a, c, d}

Departments of
^aCritical Care Medicine,
^bNeurological Surgery and
^cPediatrics, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, and
^dChildren's Hospital of Pittsburgh, Pittsburgh, Pa., USA

Address of Corresponding Author

Dev Neurosci 2006;28:342-347 (DOI: 10.1159/000094160)

  Key Words

• Child abuse
• Head injury
• Heat shock protein
• Hsp32
• Oxidative stress
• Stress response

  Abstract

Heme oxygenase 1 (HO-1) is an enzyme important in the catabolism of heme that is induced under conditions of oxidative stress. HO-1 degradation of heme yields biliverdin, bilirubin, carbon monoxide and iron. HO-1 is thought to serve a protective antioxidant function, and upregulation of HO-1 has been demonstrated in experimental models of neurodegeneration, subarachnoid hemorrhage, cerebral ischemia and traumatic brain injury (TBI). We measured HO-1 concentration in cerebral spinal fluid samples from 48 infants and children following TBI and 7 control patients by ELISA. Increased HO-1 was seen in TBI versus control patients - mean 2.75 ± 0.63, peak 4.17 ± 0.96 ng/ml versus control (<0.078 ng/ml, not detectable) (p< 0.001). Increased HO-1 concentration was associated with increased injury severity and unfavorable neurological outcome (both p < 0.05). Increased HO-1 concentration was independently associated with younger age; however, statistical analysis could not rule out the possibility that the effect of age was related to inflicted TBI from child abuse. HO-1 increases after TBI and appears to be more prominent in infants compared with older children after injury.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Robert S.B. Clark, MD
Pediatric Critical Care Medicine
3705 Fifth Avenue
Pittsburgh, PA 15213 (USA)
Tel. +1 412 692 5164, Fax +1 412 692 6076, E-Mail clarkrs@ccm.upmc.edu

  Article Information

Received: January 4, 2006
Accepted: March 29, 2006
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 3, Number of References : 38