RESUMEN
Traumatic brain injury (TBI) is a leading cause of death and disability in persons under age 45. The hallmark secondary injury profile after TBI involves dynamic interactions between inflammatory and metabolic pathways including fatty acids. Omega-3 polyunsaturated fatty acids (PUFAs) such as docosahexaenoic acid (DHA) have been shown to provide neuroprotective benefits by minimizing neuroinflammation in rodents. These effects have been less conclusive in humans, however. We postulate genetic variants influencing PUFA metabolism in humans could contribute to these disparate findings. Therefore, we sought to (1) characterize the circulating PUFA response and (2) evaluate the impact of rs174537 on inflammation after TBI. A prospective, single-center, observational pilot study was conducted to collect blood samples from Level-1 trauma patients (N = 130) on admission and 24 h post-admission. Plasma was used to quantify PUFA levels and inflammatory cytokines. Deoxyribonucleic acid was extracted and genotyped at rs174537. Associations between PUFAs and inflammatory cytokines were analyzed for all trauma cases and stratified by race (Caucasians only), TBI (TBI: N = 47; non-TBI = 83) and rs174537 genotype (GG: N = 33, GT/TT: N = 44). Patients with TBI had higher plasma DHA levels compared with non-TBI at 24 h post-injury (p = 0.013). The SNP rs174537 was associated with both PUFA levels and inflammatory cytokines (p < 0.05). Specifically, TBI patients with GG genotype exhibited the highest plasma levels of DHA (1.33%) and interleukin-8 (121.5 ± 43.3 pg/mL), which were in turn associated with poorer outcomes. These data illustrate the impact of rs174537 on the post-TBI response. Further work is needed to ascertain how this genetic variant directly influences inflammation after trauma.
Asunto(s)
Lesiones Traumáticas del Encéfalo/sangre , Lesiones Traumáticas del Encéfalo/genética , Ácidos Grasos Omega-3/sangre , Ácidos Grasos Omega-3/genética , Mediadores de Inflamación/sangre , Aciltransferasas/sangre , Adulto , Biomarcadores/sangre , Lesiones Traumáticas del Encéfalo/diagnóstico , Ácidos Grasos Insaturados/sangre , Ácidos Grasos Insaturados/genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios ProspectivosRESUMEN
This study was designed to test the hypothesis that a complex composite impedance spectra develops when stimulation and recording of cardiac muscle with sufficiently fine spatial resolution in a four-electrode configuration is used. With traditional (millimeter scale) separations, the ratio between the recorded interstitial central potential difference and total supplied interstitial current is constant at all frequencies. This occurs because the fraction of supplied current that redistributes to the intracellular compartment depends on effective membrane resistance between electrodes, which is low, to a much greater extent than effective membrane capacitance. The spectra should therefore change with finer separations at which effective membrane resistance increases, as supplied current will remain primarily interstitial at lower frequencies and redistribute between compartments at higher frequencies. To test this hypothesis, we built arrays with sensors separated (d) by 804 µm, 452 µm, and 252 µm; positioned those arrays across myocyte axes on rabbit ventricular epicardium; and resolved spectra in terms of resistivity (ρt) and reactivity (χt) over the 10 Hz to 4,000 Hz range. With all separations, we measured comparable spectra with predictions from passive membrane simulations that used a three-dimensional structural framework in which intracellular, interstitial, and membrane properties were prescribed based on the limited data available from the literature. At the finest separation, we found mean ρt at 100 Hz and 4,000 Hz that lowered from 395 Ω-cm to 236 Ω-cm, respectively, with maximal mean χt of 160 Ω-cm. This experimental confirmation of spectra development in whole heart experiments is important because such development is central to achieve measurements of intracellular and interstitial passive electrical properties in cardiac electrophysiological experiments using only interstitial access.