Poly(adenosine diphosphate-ribose) polymerase expression in human traumatic brain injury.

OBJECT: This study was designed to elucidate the pattern of expression of poly(adenosine diphosphate-ribose) polymerase (PARP) in human pericontusional brain tissue and to correlate these findings with commonly used clinical parameters.

METHODS: The expression of PARP was ascertained using immunohistochemical studies in eight specimens of human pericontusional brain tissue obtained when the patients underwent craniotomy for mass effect. The following demographic and clinical parameters were also analyzed for each patient: age, sex, postresuscitation Glasgow Coma Scale score (GCS), computerized tomography findings, intracranial pressure (ICP) recordings during the first 24 hours postsurgery, and the time interval from injury to surgery. The authors observed that PARP was present in neurons of pericontusional tissue and that it conformed to two patterns of subcellular localization; it was found either in the nucleus exclusively or in both nuclear and cytoplasmic compartments. They showed that a preponderance of cytoplasmic staining in neurons was significantly correlated with a short time interval from trauma to surgery (< or = 4 hours). There was no correlation, however, between the subcellular distribution of PARP and clinical parameters such as admission GCS score and ICP readings obtained intra- and postoperatively.

CONCLUSIONS: As in earlier studies in which it has been suggested that caspase-cleaved PARP translocates to the cytoplasm during apoptosis, the authors' results indicate that apoptosis may predominate in the initial time frame after head injury. This information may well influence the timing of administration of antiapoptotic neuronal salvage agents for adjunctive therapy of head injury in the future.