SOLUBLE ADHESION MOLECULES IN CSF ARE INCREASED IN CHILDREN WITH SEVERE HEAD-INJURY

Leukocyte-endothelial adhesion molecules, critical to the development of acute inflammation, are expressed in brain as part of the acute inf lammatory response to traumatic brain injury (TBI), We measured the co ncentrations of the adhesion molecules P-selectin, ICAM-1, E-selectin, L-selectin, and VCAM-1 in ventricular cerebrospinal fluid (CSF) from children with severe TBI (Glasgow coma score < 8) and compared these f indings with those from children with bacterial meningitis, P-selectin , an adhesion molecule associated with ischemia/reperfusion, was incre ased in children with TBI versus meningitis and control, Univariate an d multivariate regression analyses demonstrated associations between C SF P-selectin and child abuse and age of <4 years, and a significant, independent association between CSF intercellular adhesion molecule-1 (ICAM-1) and child abuse. These results are consistent with a specific acute inflammatory component to TBI in children. Future studies of se condary injury mechanisms and therapy after TBI should assess on the r oles of P-selectin and ICAM-1 in injury and repair processes in brain after TBI.