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Abstract Details

Plasma Placental Growth Factor (PlGF) is Elevated After Traumatic Brain Injury (TBI)
Neuro Trauma and Critical Care
P6 - Poster Session 6 (11:45 AM-12:45 PM)
7-009
Investigate levels of PlGF in plasma after TBI, and assess relationships to injury severity and evolution. 
PlGF is an angiogenic factor that plays a key role in vasculogenesis, wound healing, and other physiological processes. It is elevated in cases of vascular cognitive impairment/dementia in elderly patients with white matter hyperintensities (WMHs) on MRI. Microvascular disease, WMHs, and cognitive impairment are often present in victims of TBI at younger ages than in the general population. We hypothesize that PlGF is elevated in plasma after TBI. 
A subset of the TRACK-TBI cohort consisting of adults with TBI (n=367), orthopedic injury controls (OC, n=86) and healthy controls (HC, n=69) was analyzed. Plasma was collected 1 day (D1), 2 weeks (W2), and 6 months (M6) post-injury. PlGF was measured using a MesoScale Discovery (MSD) V-Plex assay. 
TBI participants had a mean (SD) age of 39.6 (16.1) years. Those with GCS 3-12 at presentation (n=179) had significantly elevated PlGF levels on D1 (median [IQR] 12.1 [8.8-16.1] pg/mL), compared to HC (9.1 [7.6-10.7] pg/mL) or OC participants (8.3 [6.3-11.0] pg/mL), p<.0001 for all comparisons. TBI subjects with GCS 13-15 (n=188) did not have elevated PlGF levels (8 [6.6-10.4] pg/mL) on D1. CT positive TBI participants (n=227) had elevated PlGF on D1 (11.4 [8.2-15.4] pg/mL) compared to CT negative participants (7.8 [6.4-10.0] pg/mL) p<.0001. PlGF remained elevated in TBI participants with GCS 3-12 (10.6 [8.6-13.6] pg/mL) compared to GCS 13-15 (7.4 [6.3-9.2] pg/mL) or OC (7.8 [6.6-9.6] pg/mL) at W2 but normalized by M6 (8.3 [6.6-9.7] pg/mL). 
PlGF is significantly elevated post-TBI in cases with GCS 3-12 on D1 and remains elevated at W2 compared to GC2 13-15 TBI or OC subjects. PlGF shows promise as a biomarker of traumatic microvascular injury, particularly in more severely injured individuals. 
Authors/Disclosures
Anna G. Mueller
PRESENTER 		An immediate family member of Ms. Mueller has received personal compensation for serving as an employee of Johns Hopkins Community Physicians. An immediate family member of Ms. Mueller has received personal compensation in the range of $100,000-$499,999 for serving as a attorney with Federal Election Comission.
Rachel E. Thomas, MD, PhD (Penn Medicine) Dr. Thomas has nothing to disclose.
Katie Brecker Mrs. Brecker has nothing to disclose.
Catherine Demos, PhD Dr. Demos has received personal compensation for serving as an employee of Meso Scale Diagnostics, LLC..
George Sigal (MesoScale Discoveries) No disclosure on file
Sonia Jain, PhD Dr. Jain has nothing to disclose.
Xiaoying Sun Mrs. Sun has nothing to disclose.
Joseph T. Giacino, PhD The institution of Dr. Giacino has received research support from National Institute on Disability, Independent Living and Rehabilitation Research. The institution of Dr. Giacino has received research support from National Institute on Neurological Disorders and Stroke. The institution of Dr. Giacino has received research support from Department of Defense. The institution of Dr. Giacino has received research support from SameYou Foundation. Dr. Giacino has received intellectual property interests from a discovery or technology relating to health care.
Michael McCrea, PhD, ABPP (Medical College of Wisconsin) Dr. McCrea has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurotrauma Sciences. The institution of Dr. McCrea has received research support from NIH. The institution of Dr. McCrea has received research support from DoD. The institution of Dr. McCrea has received research support from NCAA. The institution of Dr. McCrea has received research support from NFL. The institution of Dr. McCrea has received research support from CDC. The institution of Dr. McCrea has received research support from Abbott Labs. Dr. McCrea has received publishing royalties from a publication relating to health care.
Alexa E. Walter, PhD Dr. Walter has nothing to disclose.
David O. Okonkwo, MD, PhD Dr. Okonkwo has nothing to disclose.
Claudia Robertson (Baylor College of Medicine) The institution of Claudia Robertson has received research support from Department of Defense. The institution of Claudia Robertson has received research support from NIH. The institution of an immediate family member of Claudia Robertson has received research support from BARDA. Claudia Robertson has received personal compensation in the range of $0-$499 for serving as a DSMB member with NIH.
Nancy Temkin (University of Washington) No disclosure on file
Pratik Mukherjee, MD, PhD The institution of Dr. Mukherjee has received research support from Dept of Defense. Dr. Mukherjee has received intellectual property interests from a discovery or technology relating to health care.
Ava Puccio, PhD, RN (University of Pittsburgh) Dr. Puccio has nothing to disclose.
Andrea L. Schneider, MD, PhD (University of Pennsylvania) Dr. Schneider has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN - Neurology.
Danielle Sandsmark, MD The institution of Dr. Sandsmark has received research support from NINDS. The institution of Dr. Sandsmark has received research support from BrainBox Solutions Inc. The institution of Dr. Sandsmark has received research support from Department of Defense.
Geoffrey Manley, MD, PhD (UCSF Med Ctr/Dept of Neurosurgery) The institution of Dr. Manley has received research support from NIH-NINDS. The institution of Dr. Manley has received research support from US Department of Defense. The institution of Dr. Manley has received research support from US Department of Defense/MTEC. The institution of Dr. Manley has received research support from One Mind. The institution of Dr. Manley has received research support from Neurotrauma Sciences, LLC. The institution of Dr. Manley has received research support from NFL Scientific Advisory Board.
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania) Dr. Diaz-Arrastia has stock in BrainBox, LLC. Dr. Diaz-Arrastia has stock in Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.