Serum levels of MMP-10 and TLR2 in patients with severe traumatic brain injury underwent decompression surgery and their relationship with disease prognosis

doi:10.11958/20242355

Abstract

Abstract:

Objective To analyze the expression levels of matrix metalloproteinase-10 (MMP-10) and Toll-like receptor 2 (TLR2) in serum of patients underwent decompression surgery (DC) for severe traumatic brain injury (sTBI), and to explore their relationship with disease outcome. Methods From April 2021 to April 2024, sTBI patients (n=94) who received DC treatment in a single center were collected as the observation group. Another 90 healthy volunteers who underwent physical examinations at our hospital were selected as the control group. Six months after surgery, sTBI patients were assigned into the good group (n=53) and the adverse group (n=41) according to the Glasgow Outcome Scale (GOS). Data was collected from each group and their differences were compared. Enzyme linked immunosorbent assay (ELISA) was used to measure serum levels of MMP-10 and TLR2. Spearman method was used to analyze the correlation between MMP-10, TLR2 levels and disease outcomes. Logistic regression model used to analyze influencing factors of disease outcomes in sTBI patients after DC. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of serum MMP-10 and TLR2 levels for disease outcome in sTBI patients after DC. Results Compared with the control group, the expression levels of serum MMP-10 and TLR2 were prominently higher in the observation group (P<0.05). Compared with the good group, the proportions of sTBI patients with cerebral herniation, multiple brain contusions and lacerations, and serum levels of MMP-10 and TLR2 were significantly higher in the adverse group, while Glasgow Coma Scale (GCS) score was significantly lower (P<0.05). Serum levels of MMP-10 and TLR2 in sTBI patients were positively correlated with poor prognosis after DC (P<0.05). Elevated levels of serum MMP-10 and TLR2, and the increased proportions of patients with cerebral herniation and multiple brain contusions were risk factors affecting the disease outcome after DC in sTBI patients, while elevated GCS score was a protective factor (P<0.05). The area under the curve (AUC) for predicting disease outcome in sTBI patients after DC using serum MMP-10 and TLR2 alone and in combination was 0.839 (95%CI: 0.749-0.907), 0.847 (95%CI: 0.758-0.913) and 0.925 (95%CI: 0.852-0.969), respectively. The combined detection was superior to the individual detections (Z_{combination -MMP-10}=2.199, Z_{combination - TLR2}=2.377, both P<0.05). Conclusion The expression levels of serum MMP-10 and TLR2 in sTBI patients are significantly elevated, and both are prominently correlated with disease outcome after DC.

Key words: craniocerebral trauma, critical illness, brain edema, decompressive craniectomy, matrix metalloproteinase 10, Toll-like receptor 2, prognosis

CLC Number:

R651.11

Figures/Tables 5

References 23

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组别	n	MMP-10	TLR2
对照组	90	3.37±1.19	0.58±0.15
观察组	94	6.41±1.66	2.04±0.47
t		14.417^＊＊	28.903^＊＊

组别	n	MMP-10	TLR2
对照组	90	3.37±1.19	0.58±0.15
观察组	94	6.41±1.66	2.04±0.47
t		14.417^＊＊	28.903^＊＊

组别		n		性别（男/女）			年龄/岁				BMI/（kg/m²）				病因^a
良好组		53		31/22			58.32±8.69				23.12±4.19				13/32/8
不良组		41		22/19			61.17±7.75				23.59±4.41				10/24/7
t或χ²				0.219			1.652				0.526				0.070
组别		并发症			合并脑疝				多发脑挫裂伤				Hb/（g/L）
良好组		29（54.72）			24（45.28）				19（35.85）				112.78±24.13
不良组		23（56.10）			27（65.85）				24（58.54）				109.24±26.95
t或χ²		0.018			3.941^＊				4.794^＊				0.670
组别	GCS评分/分					WBC/（×10⁹/L）				PLT/（×10⁹/L）				CRP/（mg/L）
良好组	5.26±1.58					111.92±21.87				176.37±34.79				20.62±5.59
不良组	4.09±1.06					109.24±26.95				184.28±39.16				23.15±7.46
t	4.286^＊＊					0.532				1.034				1.889
组别			FBG/（mmol/L）					MMP-10/（μg/L）				TLR2/（μg/L）
良好组			8.29±1.76					5.63±0.93				1.62±0.58
不良组			9.11±2.32					7.42±1.71				2.59±0.77
t			1.958					6.099^＊＊				6.772^＊＊

组别		n		性别（男/女）			年龄/岁				BMI/（kg/m²）				病因^a
良好组		53		31/22			58.32±8.69				23.12±4.19				13/32/8
不良组		41		22/19			61.17±7.75				23.59±4.41				10/24/7
t或χ²				0.219			1.652				0.526				0.070
组别		并发症			合并脑疝				多发脑挫裂伤				Hb/（g/L）
良好组		29（54.72）			24（45.28）				19（35.85）				112.78±24.13
不良组		23（56.10）			27（65.85）				24（58.54）				109.24±26.95
t或χ²		0.018			3.941^＊				4.794^＊				0.670
组别	GCS评分/分					WBC/（×10⁹/L）				PLT/（×10⁹/L）				CRP/（mg/L）
良好组	5.26±1.58					111.92±21.87				176.37±34.79				20.62±5.59
不良组	4.09±1.06					109.24±26.95				184.28±39.16				23.15±7.46
t	4.286^＊＊					0.532				1.034				1.889
组别			FBG/（mmol/L）					MMP-10/（μg/L）				TLR2/（μg/L）
良好组			8.29±1.76					5.63±0.93				1.62±0.58
不良组			9.11±2.32					7.42±1.71				2.59±0.77
t			1.958					6.099^＊＊				6.772^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
MMP-10	0.654	0.183	12.788	<0.001	1.924	1.344~2.754
TLR2	0.758	0.271	7.833	0.005	2.135	1.255~3.631
GCS评分	-0.178	0.064	7.729	0.005	0.837	0.738~0.949
合并脑疝	0.332	0.126	6.950	0.008	1.394	1.089~1.784
多发脑挫裂伤	0.290	0.105	7.611	0.006	1.336	1.087~1.641
常数项	0.218	0.197	1.825	0.184	1.307