To permit appropriate targeted
therapy, the present clinical study was aimed to investigate the effects of
progesterone on the outcome and the
serum markers of injury,
oxidant activity and
inflammation in
diffuse axonal injury (DAI). Forty-eight male DAI patients were divided into two groups (control and
progesterone).
Progesterone group received
progesterone in dose of 1mg/kg per 12h for five days. The outcome was investigated using Extended Glasgow Outcome Scale (GOS-E) and functional independence measure (FIM). The markers of
inflammation [
interleukin-1β (IL-1β),
IL-6, transforming growth factor-β1 (TGF-β1)],
injury (brain protein of S-100B), and
oxidant activity [
malondialdehyde (MDA)] were evaluated in the serum of the patients. Higher GOS-E and FIM scores were observed in
progesterone group at the six-month follow-up (P<0.05 and P<0.01, respectively). Meanwhile, a reduction in the serum levels of IL-1β, MDA and S-100B was noticed in
progesterone group 24h after injury (P<0.05, P<0.001 and P<0.05, respectively), and there was an increase in serum levels of
IL-6 and TGF-β1 (P<0.01 and P<0.05, respectively). Also, lower levels of MDA and S-100B, and higher levels of TGF-β1 were observed in
progesterone group six days after injury (P<0.05). According to these findings,
progesterone may improve the outcome in DAI patients probably through modulation in the levels of
cytokines, and reduction in the injury and
oxidant activity.