Metabolic crisis after traumatic brain injury is associated with a novel microdialysis proteome.

Background: To examine if the metabolic distress after traumatic brain injury (TBI) is associated with a unique proteome.Methods: Patients with severe TBI prospectively underwent cerebral microdialysis for the initial 96 h after injury. Hourly sampling of metabolism was performed and patients were c...

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Published in:Neurocritical Care Vol. 12; no. 3; pp. 324 - 337
Main Authors: Lakshmanan R, Loo JA, Drake T, Leblanc J, Ytterberg AJ, McArthur DL, Etchepare M, Vespa PM, Lakshmanan, R, Loo, J A, Drake, T, Leblanc, J, Ytterberg, A J, McArthur, D L, Etchepare, M, Vespa, P M
Format: research Journal Article
Published: Springer Nature Jun2010
Online Access:View this record in EBSCOhost
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      dt: Jun2010
      vid: 12
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      pub: Springer Nature
      place: New York, New York
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        105189987
        NLM20225002
        2010643371
        10.1007/s12028-010-9342-5
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        atl: Metabolic crisis after traumatic brain injury is associated with a novel microdialysis proteome.
      aug:
        au:
          Lakshmanan R
          Loo JA
          Drake T
          Leblanc J
          Ytterberg AJ
          McArthur DL
          Etchepare M
          Vespa PM
          Lakshmanan, R
          Loo, J A
          Drake, T
          Leblanc, J
          Ytterberg, A J
          McArthur, D L
          Etchepare, M
          Vespa, P M
        affil: UCLA Department of Chemistry and Biochemistry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
      sug:
        subj:
          Brain Physiopathology
          Brain Injuries Physiopathology
          Energy Metabolism Physiology
          Dialysis Equipment and Supplies
          Monitoring, Physiologic Equipment and Supplies
          Proteomics
          Signal Processing, Computer Assisted Equipment and Supplies
          Blood Glucose Metabolism
          Cerebral Ischemia Diagnosis
          Cerebral Ischemia Physiopathology
          Cerebral Hemorrhage Diagnosis
          Cerebral Hemorrhage Physiopathology
          Interstitial Fluid Physiology
          Prospective Studies
          Frontal Lobe Physiopathology
          Glasgow Coma Scale
          Human
          Hypoglycemia Diagnosis
          Hypoglycemia Physiopathology
          Intracranial Pressure Physiology
          Lactic Acid Blood
          Magnetic Resonance Imaging
          Carboxylic Acids Blood
          Reference Values
          Mass Spectrometry Equipment and Supplies
          Temporal Lobe Physiopathology
          Tomography, X-Ray Computed
      ab: Background: To examine if the metabolic distress after traumatic brain injury (TBI) is associated with a unique proteome.Methods: Patients with severe TBI prospectively underwent cerebral microdialysis for the initial 96 h after injury. Hourly sampling of metabolism was performed and patients were categorized as having normal or abnormal metabolism as evidenced by the lactate/pyruvate ratio (LPR) threshold of 40. The microdialysate was frozen for proteomic batch processing retrospectively. We employed two different routes of proteomic techniques utilizing mass spectrometry (MS) and categorized as diagnostic and biomarker identification approaches. The diagnostic approach was aimed at finding a signature of MS peaks which can differentiate these two groups. We did this by enriching for intact peptides followed by MALDI-MS analysis. For the biomarker identification approach, we applied classical bottom-up (trypsin digestion followed by LC-MS/MS) proteomic methodologies.Results: Five patients were studied, 3 of whom had abnormal metabolism and 2 who had normal metabolism. By comparison, the abnormal group had higher LPR (1609 +/- 3691 vs. 15.5 +/- 6.8, P < 0.001), higher glutamate (157 +/- 84 vs. 1.8 +/- 1.4 microM, P < 0.001), and lower glucose (0.27 +/- 0.35 vs. 1.8 +/- 1.1 mmol/l, P < 0.001). The abnormal group demonstrated 13 unique proteins as compared with the normal group in the microdialysate. These proteins consisted of cytoarchitectural proteins, as well as blood breakdown proteins, and a few mitochondrial proteins. A unique as yet to be characterized peptide was found at m/z (mass/charge) 4733.5, which may represent a novel biomarker of metabolic distress.Conclusion: Metabolic distress after TBI is associated with a differential proteome that indicates cellular destruction during the acute phase of illness. This suggests that metabolic distress has immediate cellular consequences after TBI.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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