Low blood caspase-8 levels in survivor patients of traumatic brain injury

CASP8 Is a Potential Therapeutic Target and Is Correlated with Pyroptosis in Traumatic Brain Injury

BACKGROUND

Traumatic brain injury (TBI) is a major cause of neurological and psychological problems, especially long-term disability. The purpose of this article is to explore molecular mechanisms linking TBI and pyroptosis with the aim of providing a promising target for future therapeutic interventions.

METHODS

GSE104687 microarray dataset was downloaded from the Gene Expression Omnibus database to obtain differential expressed genes. Meanwhile, pyroptosis-related genes were screened from GeneCards database, and the overlapped genes were considered as the pyroptosis-related genes in TBI. The immune infiltration analysis was conducted to quantify lymphocyte infiltration levels. Moreover, we researched the relevant microRNAs (miRNAs) and transcription factors and investigated the interactions and functions of miRNAs. In addition, the validation set and in vivo experiment further verified the expression of hub gene.

RESULTS

Altogether, we found 240 differential expressed genes in GSE104687 and 254 pyroptosis-related genes in the GeneCards database, and the overlapped gene was caspase 8 (CASP8). Immune Infiltration Analysis suggested the abundance of Tregs cells was significantly higher in TBI group. The NKT and CD8+ Tem were positively correlated with the expression levels of CASP8. The most significant term regarding CASP8 in Reactome pathways analysis was related to NF-kappaB. A total of 20 miRNAs and 25 transcription factors associated with CASP8 were obtained. After investigating the interactions and functions of miRNAs, the NF-kappaB-related signaling pathway was still enriched with a relatively low P-value. The validation set and in vivo experiment further verified the expression of CASP8.

CONCLUSIONS

Our study showed the potential role of CASP8 in pathogenesis of TBI, which may provide a new target for individualized therapy and drug development.

Activation of NLRP3 Is Required for a Functional and Beneficial Microglia Response after Brain Trauma

Despite the numerous research studies on traumatic brain injury (TBI), many physiopathologic mechanisms remain unknown. TBI is a complex process, in which neuroinflammation and glial cells play an important role in exerting a functional immune and damage-repair response. The activation of the NLRP3 inflammasome is one of the first steps to initiate neuroinflammation and so its regulation is essential. Using a closed-head injury model and a pharmacological (MCC950; 3 mg/kg, pre- and post-injury) and genetical approach (NLRP3 knockout (KO) mice), we defined the transcriptional and behavioral profiles 24 h after TBI. Wild-type (WT) mice showed a strong pro-inflammatory response, with increased expression of inflammasome components, microglia and astrocytes markers, and cytokines. There was no difference in the IL1β production between WT and KO, nor compensatory mechanisms of other inflammasomes. However, some microglia and astrocyte markers were overexpressed in KO mice, resulting in an exacerbated cytokine expression. Pretreatment with MCC950 replicated the behavioral and blood-brain barrier results observed in KO mice and its administration 1 h after the lesion improved the damage. These findings highlight the importance of NLRP3 time-dependent activation and its role in the fine regulation of glial response.

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

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 the severity of the injury.

Methods

The analysis was performed on 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 h after trauma and on days 3 and 7 after admission. The concentrations of selected caspases were determined and correlated with the severity of brain injury evaluated by the Rotterdam CT Score, Glasgow Coma Score, and 28-day mortality.

Results

Our results showed significantly elevated levels of selected caspases on days 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 the 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.

The Role of Caspase Family in Acute Brain Injury: The Potential Therapeutic Targets in the Future

The caspase family is commonly involved in the pathophysiology of acute brain injury (ABI) through complex apoptotic, pyroptotic, and inflammatory pathways. Current translational strategies for caspase modulation in ABI primarily focus on caspase inhibitors. Because there are no caspase-inhibiting drugs approved for clinical use on the market, the development of caspase inhibitors remains an attractive challenge for researchers and clinicians. Therefore, we conducted the present review with the aim of providing a comprehensive introduction of caspases in ABI. In this review, we summarized the available evidence and potential mechanisms regarding the biological function of caspases. We also reviewed the therapeutic effects of caspase inhibitors on ABI and its subsequent complications. However, various important issues remain unclear, prompting further verification of the efficacy and safety regarding clinical application of caspase inhibitors. We believe that our work will be helpful to further understand the critical role of the caspase family and will provide novel therapeutic potential for ABI treatment.