IMR Press / JIN / Volume 22 / Issue 2 / DOI: 10.31083/j.jin2202049
Open Access Original Research
Concentration of Apoptotic Factors in Bronchoalveolar Lavage Fluid, as Potential Brain-Lung Oxygen Relationship, Correspond to the Severity of Brain Injury
Show Less
1 Department of Anaesthesiology, Intensive Care Medical University of Lublin, 20-059 Lublin, Poland
2 Collegium Medicum, Department of Surgical Medicine with the Laboratory of Medical Genetics, Jan Kochanowski University, 25-369 Kielce, Poland
3 Anaesthesia and Intensive Care, Policlinico San Martino, Deputy of the Neurointensive Care Section of European Society of Intensive Care Medicine, 16122 Genova, Italy
4 Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Genova, Poland
5 Department of Physiotherapy, Medical University of Lublin, 20-059 Szczecin, Poland
*Correspondence: (Dorota Siwicka-Gieroba); (Chiara Robba)
J. Integr. Neurosci. 2023, 22(2), 49;
Submitted: 13 October 2022 | Revised: 24 December 2022 | Accepted: 28 December 2022 | Published: 6 March 2023
(This article belongs to the Special Issue Hypoxia and Brain Function)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: The mechanism of acute brain injury initiates a cascade of consequences which can directly cause lung damage, and this can contribute to poor neurological outcomes. The aim of this study was to evaluate concentration of different apoptotic molecules in the bronchoalveolar lavage fluid (BALF) in patients after severe brain injury and to correlate them with selected clinical variables and mortality. Methods: Patients with brain injury receiving BALF operation were included in the study. BALF samples were collected within the first 6–8 hours after traumatic brain injury (A) and at days 3 (B) and 7 (C) after admission to the intensive care unit (ICU). Changes in the BALF nuclear-encoded protein (Bax), apoptotic regulatory protein (Bcl-2), pro-apoptotic protein (p53) and its upregulated modulator (PUMA), apoptotic protease factor 1 (APAF-1), Bcl-2 associated agonist of cell death (BAD) and caspase-activated DNase (CAD) were analysed. These values were correlated with the selected oxygenation parameters, Rotterdam computed tomography (CT) score, the Glasgow Coma Score and 28-day mortality. Results: We found a significant increase in the concentration of selected apoptotic factors at admission (A), at day 3 (B) and day 7 (C) after severe brain damage contrasted with baseline level A (p < 0.001, separately). That concentration of selected apoptotic factors was significantly correlated with the severity of the injury and mortality. Conclusions: Activation of different apoptotic pathways seems to be an important process occurring in the lungs of patients in the early phases after severe brain trauma. Levels of apoptotic factors in the BALF correlates with the severity of brain injury.

brain injuries
brai-lung crosstalk
Fig. 1.
Back to top