Relationship of Circulating CXCR4+ EPC with Prognosis of Mild Traumatic Brain Injury Patients

To investigate the changes of circulating endothelial progenitor cells (EPCs) and stromal cell-derived factor-1 alpha (SDF-1 alpha)/CXCR4 expression in patients with mild traumatic brain injury (TBI) and the correlation between EPC level and the prognosis of mild TBI. 72 TBI patients (57 mild TBI, 15 moderate TBI patients) and 25 healthy subjects (control) were included. The number of circulating EPCs, CD34(+), and CD133(+) cells and the percentage of CXCR4(+) cells in each cell population at 1,4,7,14,21 days after TBI were counted by flow cytometer. SDF-1 alpha levels in serum were detected by ELISA assay. The patients were divided into poor and good prognosis groups based on Extended Glasgow Outcome Scale and Activity of Daily Living Scale at 3 months after TBI. Correlation analysis between each detected index and prognosis of mild TBI was performed. Moderate TBI patients have higher levels of SDF-1 alpha and CXCR4 expression than mild TBI patients (P < 0.05). The percentage of CXCR4(+) EPCs at day 7 post-TBI was significantly higher in mild TBI patients with poor prognosis than the ones with good prognosis (P < 0.05). HAMA and HAMD scores in mild TBI patients were significantly lower than moderate TBI patients (P < 0.05) in early term. The percentage of CXCR4(+) EPCs at day 7 after TBI was significantly correlated with the prognosis outcome at 3 months. The mobilization of circulating EPCs can be induced in mild TBI. The expression of CXCR4(+) in EPCs at 7 days after TBI reflects the short-term prognosis of brain injury, and could be a potential biological marker for prognosis prediction of mild TBI.