The Connection Between Selected Caspases Levels in Bronchoalveolar Lavage Fluid and Severity After Brain Injury

Dorota Siwicka-Gieroba; Sylwia Terpilowska; Chiara Robba; Małgorzata Barud; Agnieszka Kubik-Komar; Wojciech Dabrowski

doi:10.3389/fneur.2022.796238

The Connection Between Selected Caspases Levels in Bronchoalveolar Lavage Fluid and Severity After Brain Injury

Front Neurol. 2022 May 19:13:796238. doi: 10.3389/fneur.2022.796238. eCollection 2022.

Authors

Dorota Siwicka-Gieroba¹, Sylwia Terpilowska², Chiara Robba³, Małgorzata Barud¹, Agnieszka Kubik-Komar⁴, Wojciech Dabrowski¹

Affiliations

¹ Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
² Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland.
³ Anaesthesia and Intensive Care, Policlinico San Martino, Deputy of the Neurointensive Care Section of European Society of Intensive Care Medicine, Genova, Italy.
⁴ Department of Applied Mathematics and Computer Science, University of Life Sciences in Lublin, Lublin, Poland.

Abstract

Objective: The interaction between the brain and lungs has been the subject of many clinical reports, while the exact impact of brain injury on the physiology of the respiratory system is still subject to numerous experimental studies. The purpose of this study was to investigate the activation of selected caspases levels in bronchoalveolar lavage fluid (mini BALF) of patients after isolated brain injury and their correlation with the severity of the injury.

Methods: The analysis was performed on patients who were admitted to the intensive care unit (ICU) for severe isolated brain injury from March 2018 to April 2020. All patients were intubated and mechanically ventilated. Mini BALF was collected within the first 6-8 h after trauma and on days 3 and 7 after admission. The concentrations of selected caspases were determined and correlated with the severity of brain injury evaluated by the Rotterdam CT Score, Glasgow Coma Score, and 28-day mortality.

Results: Our results showed significantly elevated levels of selected caspases on days 3 and 7 after brain injury, and revealed apoptosis activation during the first 7 days after brain trauma. We found a significant different correlation between the elevation of selected caspases 3, 6, 8, and 9, and the Glasgow Coma Score, Rotterdam CT scale, and 28-day mortality.

Conclusions: The increased levels of selected caspases in the mini BALF in our patients indicate an intensified activation of apoptosis in the lungs, which is related to brain injury itself via various apoptotic pathways and correlates with the severity of brain injury.

Keywords: ICU; brain; brain injuries; caspases; lung injury.