Probability of Soluble Tissue Factor Release Lead to the Elevation of D-dimer as a Biomarker for Traumatic Brain Injury

Access this Article

Author(s)

    • SUEHIRO Eiichi
    • Department of Neurosurgery, Yamaguchi University Graduate School of Medicine
    • FUJIYAMA Yuichi
    • Department of Neurosurgery, Yamaguchi University Graduate School of Medicine
    • KIYOHIRA Miwa
    • Department of Neurosurgery, Yamaguchi University Graduate School of Medicine
    • MOTOKI Yukari
    • Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine
    • NOJIMA Junzo
    • Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine
    • SUZUKI Michiyasu
    • Department of Neurosurgery, Yamaguchi University Graduate School of Medicine

Abstract

<p><span style="font-variant: small-caps;">d</span>-dimer is a potential biomarker for the detection of traumatic brain injury (TBI). However, the mechanisms that trigger elevation of <span style="font-variant: small-caps;">d</span>-dimer in TBI remain unclear. The purpose of this study was to evaluate the reliability of <span style="font-variant: small-caps;">d</span>-dimer in blood as a biomarker for TBI and to determine the mechanisms involved in regulating its blood levels. Nine patients with moderate to severe isolated TBI (Glasgow Coma Scale [GCS] score 7–13) were admitted to our hospital from May 2013 to June 2014. Blood samples were collected from systemic arteries on arrival and at 1, 3, 5, and 7 days after injury. Blood levels of neuron specific enolase (NSE), <span style="font-variant: small-caps;">d</span>-dimer, and soluble tissue factor (sTF) were measured. NSE (33.4 ng/ml: normal <12.0 ng/ml) and <span style="font-variant: small-caps;">d</span>-dimer (56.1 μg/ml: normal <1.0 μg/ml) were elevated at admission and declined on day 1 after injury. At admission, there were significant correlations of <span style="font-variant: small-caps;">d</span>-dimer levels with NSE (<i>R</i> = 0.727, <i>P</i> = 0.026) and sTF (<i>R</i> = 0.803, <i>P</i> = 0.009) levels. The blood level of <span style="font-variant: small-caps;">d</span>-dimer accurately reflects the degree of brain tissue damage indicated by NSE levels. Our data suggest that release of sTF induced by brain tissue damage may activate the coagulation cascade, leading to elevation of <span style="font-variant: small-caps;">d</span>-dimer.</p>

Journal

  • Neurologia medico-chirurgica

    Neurologia medico-chirurgica, 2019

    The Japan Neurosurgical Society

Codes

Page Top