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Abstract Details

Angiopoietin2 (Ang2) Levels are Associated with Increased Severity and Unfavorable Outcomes in Traumatic Brain Injury (TBI): A TRACK-TBI Study
Neuro Trauma and Critical Care
S17 - Neurocritical Care (1:00 PM-1:12 PM)
001
Ang2 is a naturally occurring antagonist of Tie2 which plays a role in pathophysiological processes related to vascular injury and repair. TBI is often associated with microvascular disruption, and we hypothesize that Ang2 levels measured in plasma are a sensitive biomarker of microvascular injury.
Describe the relationship of Ang2 levels in plasma with TBI severity, CT findings, and how it evolves in the first two weeks after injury.

A subset of the TRACK-TBI cohort consisting of adults with TBI (n=362), orthopedic injury controls (OI, n=89), and healthy controls (HC, n=64) was analyzed. Plasma was collected at 1 day (D1), 2 weeks (W2), and 6 months (M6) after injury, and Ang2 levels were measured using Meso Scale Discovery (MSD) R-PLEX assay. Glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) were measured on MSD Neurology Panel S-Plex.
 The mean age of the TBI participants was 39.8 years. 174 (48%) were GCS 13-15, and 188 (52%) were GCS 3-12. D1 Ang2 levels (median [IQR]) in TBI cases were 2.4 [1.8–3.9] ng/mL, compared to 1.7 [1.3–2.1] ng/mL in HC (p<0.001) and 2.2 [1.6–2.7] ng/mL in OI (p=0.008). Ang2 remained elevated at W2 in GCS 3-12 cases (3.3 [2.3–5.1] ng/mL), but returned to normal by M6. In the GCS 13-15 cases, Ang2 levels had returned to normal by W2. Higher levels on D1 and W2 are associated with TBI severity. D1 Ang2 levels in cases with abnormal CT was 2.9 [2.0–4.5] ng/mL, while in CT negative cases it was 2.0 [1.5–2.5] ng/mL (p<0.0001).
Ang2 is increased after TBI, and in severely injured cases higher levels persist for 2 weeks. Ang2 is a biomarker of traumatic microvascular injury and deserves further investigation.
Authors/Disclosures
Andres Nunez
PRESENTER 		Mr. Nunez has nothing to disclose.
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..
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.
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.
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.
Kevin Wang (Morehouse School Of Medicine) Kevin Wang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott Diagnostics. Kevin Wang has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for WorldClass Seminar. Kevin Wang has stock in Gryphon Bio, Inc. Kevin Wang has stock in Owl Therapeutics, LLC. The institution of Kevin Wang has received research support from National Institute of Helath. The institution of Kevin Wang has received research support from US Department of Defense.
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.
Alexa E. Walter, PhD Dr. Walter has nothing to disclose.
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.