Soluble vascular adhesion protein-1: decreased activity in the plasma of trauma victims and predictive marker for severity of traumatic brain injury.

BACKGROUND: This study done was to investigate the clinical significance of soluble vascular adhesion protein-1 (sVAP-1) activity in trauma patients with different patterns.
METHODS: 96 patients with consecutive trauma ≥15 years who were admitted to emergency department of the Second Affiliated Hospital, Shantou University Medical College, China, between January 2007 and December 2009 were enrolled in this study. Plasma was collected at admission. Injury-severity score (ISS) and Glasgow Coma Scale (GCS) were used to determine the patient conditions. sVAP-1 activity was determined by using the high performance liquid chromatographic (HPLC) system.
RESULTS: Mean sVAP-1 activity in trauma patients was significantly lower than that of controls (P<0.0001), and the level was negatively correlated with circulating leucocytes and neutrophils (P<0.0001). There was a significant correlation between lower sVAP-1 activity and injury patterns. However, plasma sVAP-1 activity increased significantly in accordance with the severity of traumatic brain injury (TBI), and the patients with sVAP-1 value above 8.61 nmol/ml/h have much higher mortality rate (25.0%) than patients with sVAP-1 value lower than 8.61 nmol/ml/h (0.0%) (P=0.011).
CONCLUSIONS: Trauma patients had a decreased sVAP-1 activity. However, isolated TBI patients with higher activity of sVAP-1 at admission were more likely to have a poor outcome.