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Weiss E, Dhir T, Collett A, et al. Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model. Clin Exp Emerg Med. 2020;7(2):87-94doi: 10.15441/ceem.19.050.
Weiss, E., Dhir, T., Collett, A., Reola, M., Kaplan, M., Minimo, C., Omert, L., & Leung, P. (2020). Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model. Clinical and experimental emergency medicine, 7(2), 87-94. https://doi.org/10.15441/ceem.19.050
Weiss, Eric, et al. "Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model." Clinical and experimental emergency medicine vol. 7,2 (2020): 87-94. doi: https://doi.org/10.15441/ceem.19.050
Weiss E, Dhir T, Collett A, Reola M, Kaplan M, Minimo C, Omert L, Leung P. Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model. Clin Exp Emerg Med. 2020 Jun;7(2):87-94. doi: 10.15441/ceem.19.050. Epub 2020 Jun 30. PMID: 32635699; PMCID: PMC7348678.
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Clin Exp Emerg Med. 2020 Jun;7(2):87-94. doi: 10.15441/ceem.19.050. Epub 2020 Jun 30.

Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model.

Clinical and experimental emergency medicine

Eric Weiss, Teena Dhir, Abigail Collett, Michal Reola, Mark Kaplan, Corrado Minimo, Laurel Omert, Pak Leung

Affiliations

  1. Department of Surgery, Einstein Healthcare Network, Philadelphia, PA, USA.
  2. Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
  3. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 32635699 PMCID: PMC7348678 DOI: 10.15441/ceem.19.050

Abstract

OBJECTIVE: Traumatic brain injury (TBI) is characterized by damage to the blood-brain barrier, inflammation, and edema formation. In this pilot study, we aimed to investigate the effects of a complement inhibitor, C1-esterase inhibitor (C1 INH), on brain edema and inflammation in a rat model of mild TBI.

METHODS: Thirty-six male Sprague Dawley rats were randomly assigned to control, TBI, or TBI plus C1 INH groups. TBI and TBI plus C1 INH rats received an injection of saline or 25 IU/kg C1 INH, respectively, with TBI using a weight drop model. Control rats received saline only. Rats were subsequently euthanized and their brain tissue harvested for analysis. The primary outcome was the extent of edema as assessed by the brain's water content. Secondary outcomes included enzyme-linked immunosorbent assays to determine levels of pro-inflammatory mediators.

RESULTS: Tumor necrosis factor-α levels were significantly greater in TBI rats than control rats, indicating that inflammation was generated by the weight drop impact. Brain water content following TBI was significantly different between TBI rats treated with C1-INH (78.7%±0.12), untreated TBI rats (79.3%±0.12), and control rats (78.6%±0.15, P=0.001). There was a significant decrease in C3a and interleukin 2 levels among C1 INH-treated rats compared with untreated TBI rats, but no change in levels of tumor necrosis factor-α and S100β.

CONCLUSION: C1-INH inhibited the complement pathway, suggesting that C1-INH may have a therapeutic benefit in TBI. Further studies are needed to investigate the effect of C1-INH on clinical outcomes.

Keywords: Brain injuries, traumatic; Complement system proteins; Cytokines; Edema; Inflammation

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