Spectrin breakdown products in the cerebrospinal fluid in severe head injury--preliminary observations.
ABSTRACT Calcium-induced proteolytic processes are considered key players in the progressive pathobiology of traumatic brain injury (TBI). Activation of calpain and caspases after TBI leads to the cleavage of cytoskeletal proteins such as non-erythroid alpha II-spectrin. Recent reports demonstrate that the levels of spectrin and spectrin breakdown products (SBDPs) are elevated in vitro after mechanical injury, in the cerebrospinal fluid (CSF) and brain tissue following experimental TBI, and in human brain tissue after TBI.
This study was initiated to detect spectrin and SBDP accumulation in the ventricular CSF of 12 severe TBI-patients with raised intracranial pressure (ICP). Nine patients with non-traumatically elevated ICP and 5 undergoing diagnostic lumbar puncture (LP) served as controls. Intact spectrin and calpain and caspase specific SBDPs in CSF collected once a day over a several day period were assessed via Western blot analysis. Parameters of severity and outcome such as ICP, Glasgow Coma Scale and Glasgow Outcome Scale were also monitored in order to reveal a potential correlation between these CSF markers and clinical parameters.
In control patients undergone LP no immunoreactivity was detected. Non-erythroid alpha-II-spectrin and SBDP occurred more frequently and their level was significantly higher in the CSF of TBI patients than in other pathological conditions associated with raised ICP. Those TBI patients followed for several days post-injury revealed a consistent temporal pattern for protein accumulation with the highest level achieved on the 2(nd) -3(rd) days after TBI.
Elevation of calpain and caspase specific SBDPs is a significant finding in TBI patients indicating that intact brain spectrin- and SBDP-levels are closely associated with the specific neurochemical processes evoked by TBI. The results strongly support the potential utility of these surrogate markers in the clinical monitoring of patients with severe TBI and provide further evidence of the role of calcium-induced, calpain- and caspase-mediated structural proteolysis in TBI.
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ABSTRACT: Calpain, a calcium-activated neutral protease family, has been implicated in the neuropathologic sequelae accompanying various neurological disorders. We have characterized the distribution and time course of calpain activation following brain injury in the rat, using a monoclonal antibody that recognizes calpain-generated breakdown products (BDPs) of spectrin. Adult male Sprague-Dawley rats received lateral fluid percussion brain injury of moderate severity (2.2-2.4 atm, n = 35) or served as controls (uninjured, n = 12). One group of animals (n = 21) were sacrificed at either 30 minutes (min), 1 day, or 3 days post-injury, and selected brain regions were prepared for Western blot analysis. The remaining animals (n = 26) were sacrificed at 90 min, 4 hours (h), 1 day, or 7 days post-injury, and immunohistochemistry was performed. Spectrin BDPs were found predominantly in the hemisphere ipsilateral to the injury site, located primarily in cortical and hippocampal regions which exhibit neuronal death. Calpain-mediated spectrin breakdown was detected at 90 min in dendrites and axons, and by 4 h in neuronal perikarya. By 1 day post-injury, cortical and hippocampal regions of calpain activation had increased in size. Delayed spectrin breakdown was observed in the thalamus, both at 3 days and 7 days after injury. These results suggest that calpain may play an important role in the neurodegenerative process following brain injury.Journal of Neuropathology and Experimental Neurology 08/1996; 55(7):850-60. · 4.35 Impact Factor
- Journal of Neurotrauma - J NEUROTRAUMA. 01/1997; 14(6):369-383.
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ABSTRACT: The experimental and clinical study of degenerative brain disorders would benefit from new surrogate markers for brain damage. To identify novel candidate markers for acute brain injury, we report that rat cortical neurons release over 60 cytoskeletal and other proteins, as well as their proteolytic fragments into the medium during neuronal death. The profiles of released proteins differ for necrosis and apoptosis, although a subset of proteins is released generally during neurodegeneration. The value of this approach was established by immunodetection of the released proteins 14-3-3 zeta and 14-3-3 beta, as well as calpain and caspase derivatives of tau and alpha-spectrin in cerebrospinal fluid (CSF) following traumatic brain injury (TBI) or transient forebrain ischemia in the rat. These results indicate that proteins and their proteolytic fragments released from degenerating neurons are cerebrospinal fluid markers for acute brain damage and suggest that efflux of proteins from the injured brain may reflect underlying mechanisms for neurodegeneration.Neurobiology of Disease 08/2004; 16(2):311-20. · 5.62 Impact Factor