目的 分析血清硫氧还蛋白1 (thioredoxin 1,Trx1)水平同脑外伤病情严重程度和预后的关系。方法 选择东莞市松山湖中心医院84例脑外伤患者,按照格拉斯哥昏迷指数(Glasgow coma scale,GCS)将其分为A组(重度,GCS为3~8分,n=29)、B组(中度,GCS为9~12分,n=31)、C组(轻度,GCS为13~15分,n=24),所有患者随访后均按照死亡和持续性神经退行性病变发生情况分为D组和E组,分别在入院时、30 d后测量患者的脑白质FA值和血清Trx1指标,比较各组间上述指标,分析血清Trx1对患者预后的影响。结果 C组入院时的血清Trx1水平、脑白质各区FA值均比A组、B组明显增加,差异有统计学意义(P<0.05)。入院30 d后各组的脑白质各区FA值均比入院时明显增加,差异具统计学意义(P<0.05),C组30 d后的脑白质各区FA值和血清Trx1水平均比A组、B组明显增加,差异具统计学意义(P<0.05);D组的血清Trx1水平比E组的明显降低,差异具统计学意义(P<0.05),血清Trx1水平同患者死亡和持续性神经退行性病变的发生相关(r=0.824,P<0.05);Trx1水平同患者右侧扣带束、右侧内囊前肢、左侧扣带束、胼胝体压部FA值相关(r分别为0.841,0.759,0.710,0.708,P<0.05)。结论 Trx1同脑外伤患者的病情严重程度密切相关,可预测患者脑白质的恢复和预后情况。
Abstract
Objective To analyze the association of Trx1 levels with the prognosis of patients with brain injury.Methods Eighty-four patients with brain trauma hospitalized in our hospital between February 2017 and August 2018 were divided into the severe group (group A,GCS 3-8,n=29),moderate group ( group B,GCS 9-12,n=31) and mild group (group C,GCS 13-15,n=24) based on GCS.After follow-up,these patients were re-divided into the survival group (group D) and death group (group E) according to their mortality and occurrence of persistent neurodegenerative disease.The FA value of white matter and serum Trx1 index were both measured upon admission and 30 days after admission,respectively.FA values and Trx1 levels were compared between these groups to find out about the influence of serum Trx1 on the prognosis of patients.Results The Trx1 level in group C was significantly higher than that in group A and group B (P<0.05),and FA values of each area of white matter were significantly higher in group C than those in group A and group B (P<0.05).30 days after admission,FA values of each area of white matter increased significantly in each group (P<0.05),and the FA values of each area of white matter and serum Trx1 were also higher in group C than those in group A and B (P<0.05).The serum Trx1 level in group D was significantly lower than that in group E (P<0.05),which was associated with the occurrence of persistent neurodegenerative disease and mortality.TheTrx1 level was associated with FA values of the right cingulate tract,right anterior limb of the internal capsule,left cingulate tract and corpus callosum pressure (r=0.841,0.759,0.710,0.708,P<0.05).Conclusions Trx1 is closely related to the severity of brain injury and can help predict the recovery and prognosis of white matter.
关键词
硫氧还蛋白1 /
预后 /
脑外伤 /
严重程度
Key words
thioredoxin 1 /
prognosis /
brain injury /
severity
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Mohindru P,Khanna R,Bhatia S S.Official stats underestimate brain injury[J].SH News,2012,1(1):1595.
[2] Cheng P,Yin P,Ning P,et al.Trends in traumatic brain injury mortality in China,2006-2013:A population-based longitudinal study[J].PLoS Med,2017,14:e1002332.
[3] Masutani H,Yoshihara E,Masaki S,et al.Thioredoxin binding protein(TBP)-2/Txnip andα-arrestin proteins in cancer and diabetes mellitus[J].J Clin Biochem Nutr,2012,50(1):23-34.
[4] Wu J,Lin H,Liu D,et al.The protective effect of telmisartan in type 2 diabetes rat kidneys is related to the downregulation of thioredoxin-interacting protein[J].J Endocrinol Invest,2013,36(7):453-459.
[5] 陈伟巍,王 敏,吴明辉.Trx-1过表达通过NF-κB信号通路减轻MPP+所致PC12细胞的氧化应激损伤[J].中国病理生理杂志,2019,35(7):1206-1212.
[6] 曾志明,罗方接,邓景阳,等.血清硫氧还蛋白1与脑外伤患者的白质恢复的相关性分析[J].基因组学与应用生物学,2019,38(5):2410-2414.
[7] Mierzwa A J,Marion C M,Sullivan G M,et al.Components of myelin damage and repair in the progressio n of white matter pathology after mild traumatic brain injury[J].J Neuropathol Exp Neurol,2015,74(3):218-232.
[8] Beninson L,Tannura K,Greenwood B N,et al.The inflammasome and danger associated molecular patterns (DAMPs) are implicated in cytokine and chemokine responses following stressor exposure[J].Brain,Brain Behav Immun,2013,28(2):54-62.
[9] Dennis E L,Rashid F,Ellis M U,et al.Diverging white matter trajectories in children after traumatic brain injury:The RAPBI study[J].Neurology,2017,88(15):1392-1399.
[10] Moolla,Naazneen,Killick,Mark,Papathanasopoulos,Maria,et al.Thioredoxin (Trx1) regulates CD4 membrane domain localization and is required for efficient CD4-dependent HIV-1 entry[J].BBA-General Subjects,2016,1860(9):1854-1863.
[11] Ago,Tetsuro,Nagarajan,Narayani,Wu,Changgong,et al.Master redox regulator Trx1 upregulates SMYD1 &modulates lysine methylation[J].Biochimica et Biophysica Acta(BBA)-Proteins and Proteomics,2015,1854(12):1816-1822.
[12] 杨黎华.硫氧还蛋白-1调节环境毒性物吗啡、甲基苯丙胺诱导脑损伤的分子机制[D].昆明:昆明理工大学,2018.
[13] 王 涛,费成平,王 宇,等.硫氧还蛋白-1小干扰RNA加剧脂多糖诱导的大鼠肝细胞内质网应激[J].中华危重病急救医学,2016,28(4):298-302.
[14] Zeng X S,Jia J J,Kwon Y,et al.The role of thioredoxin-1 in suppression of endoplasmic reticulum stress in Parkinson disease[J].Free Radic Biol Med,2014,67:10-18.
[15] Zhu Kunting,He Qi,Li Lingyu,et al.Silencing thioredoxin1 exacerbates damage of astrocytes exposed to OGD/R by aggravating apoptosis through the Actin-Ras2-cAMP-PKA pathway[J].Int J Neurosci,2018,128(6):512-519.
[16] Wang Xiao Na,Gu Li,Gao Wei,et al.Control of Trx1 redox state modulates protection against methyl methanesulfonate-induced DNA damage via stabilization of p21[J].J Biochem,2016,159(1):101-110.
[17] Oberacker T,Bajorat J,Ziola S,et al.Enhanced expression of thioredoxin- interacting- protein regulates oxidative DNA damage and aging[J].FEBS Lett,2018,592(13):2297-2307.
基金
2018年东莞市社会科技发展(一般)项目(20185071150241546)
PDF(614 KB)
