Ulus Travma Acil Cerrahi Derg. 2007; 13(4): 281-287

Aðýr kafa travmalý hastalarda beyin omurilik sývýsý ve serum IGF-1 ve IGFBP-3 deðerleri

Galip Zihni Sanus¹, Taner Tanrýverdi¹, Abdurrahman Coþkun², Hakan Hanýmoðlu¹, Merih Is³, Mustafa Uzan^1
1Ý.ü. Cerrahpaþa Týp Fakültesi, Nöroþirürji Anabilim Dalý, Ýstanbul
²Abant Ýzzet Baysal Üniversitesi, Biyokimya Anabilim Dalý, Düzce
³Abant Ýzzet Baysal Üniversitesi, Nöroþirürji Anabilim Dalý, Düzce

AMAÇ: Bu çalýþmanýn amacý, insülin benzeri büyüme faktörü-1 (IGF-1) ve insülin-benzeri baðlama protein-3 (IGFBP-3) moleküllerinin ciddi kafa travmasý sonrasý serumda ve beyin omurlik sývýsý’ndaki (BOS) seviyelerini ölçmek ve kontrol grubu ile karþýlaþtýrmaktýr.
GEREÇ-YÖNTEM: Travma ve kontrol gruplarýmýzý sýrasý ile aðýr kafa travmalý 11 hasta ile 9 hidrosefalili (bir hasta normal basýnçlý diðer sekiz hasta akuaduktus stenozuna baðlý hidrosefali) hasta oluþturdu. Hastalardan alýnan serum ve BOS örneklerinde IGF-1 ve IGFBP-3 seviyeleri kafa travmasý sonrasý ölçüldü ve seviyeleri kontrol grubu ile karþýlaþtýrýldý. BULGULAR: Gerek hasta ve gerekse de kontrol grubunda BOS, IGF-1 ve IGFBP-3 seviyeleri ölçülemeyecek derecede düþüktü. Serum seviyelerine bakýldýðýnda ise, hasta grubu kontrol grubuna göre her zaman daha yüksek IGF-1 ve IGFBP-3 deðerleri saptandý. SONUÇ: Aðýr kafa travmasýnýn akut veya kronik dönemlerde IGF-1 verilmesi yarar saðlayabilir ve insanlarda mortalite ve morbiditeyi azaltabilir.

Anahtar Kelimeler: Beyin travmasý/ilaç tedavisi, ciddi kafa yaralanmasý; IGF-1; IGFBP-3; immünohistokimya/yöntem; nöron korunmasý.

---

Cerebrospinal fluid and serum levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 in patients with severe head injury

Galip Zihni Sanus¹, Taner Tanrýverdi¹, Abdurrahman Coþkun², Hakan Hanýmoðlu¹, Merih Is³, Mustafa Uzan^1
1Department Of Neurosurgery, Istanbul University Cerrahpaþa Medical Faculty, Istanbul
²Department Of Biochemistry, Medicine Faculty Of Abant Izzet Baysal University, Düzce, Turkey
³Department Of Neurosurgery, Medicine Faculty Of Abant Izzet Baysal University, Düzce, Turkey

BACKGROUND: The aim of this study is to present time course of insulin like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in both cerebrospinal fluid (CSF) and serum of patients after severe head injury (SHI) and to compare with controls. METHODS: Our trauma and control groups included 11 consecutive patients with isolated SHI and 9 patients with hydrocephalus (one with normotensive and eight with hydrocephalus due to aqueduct stenosis), respectively. Both serum and cerebrospinal fluid levels of IGF-1 and IGFBP-3 were measured during post-traumatic days and we compared the levels with controls. RESULTS: Patients and controls showed undetectable levels of both IGF-1 and IGFBP-3 in their CSF. When considering serum levels, patients with SHI had always lower levels of both molecules than that of controls. CONCLUSION: Administration of IGF-1 during acute, as well as chronic phase of severe head trauma may provide beneficial effects and may decrease both mortality and morbidity in humans with SHI.

Keywords: Brain trauma/drug therapy, IGF-1; IGFBP-3; immunohistochemistry/methods; neuroprotection; severe head injury.

---

ATIF KOPYALA