AUTHOR=Siwicka-Gieroba Dorota , Terpilowska Sylwia , Robba Chiara , Barud Małgorzata , Kubik-Komar Agnieszka , Dabrowski Wojciech 

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

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.796238

DOI=10.3389/fneur.2022.796238

ISSN=1664-2295

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 severity of injury.
Methods: The analysis was performed in 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 hours after trauma and at day 3 and 7 after admission. The concentrations of selected caspases were determined and correlated with the severity of brain injury evaluated by Rotterdam CT Score, Glasgow Coma Score and 28-day mortality. 
Results: Our results showed significantly elevated levels of selected caspases at day 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 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.