{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:20:48Z","timestamp":1764307248112,"version":"3.46.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ttraumatic brain injury (TBI) induces oxidative stress, which contributes to neuronal damage and cognitive impairment. Apolipoprotein E (ApoE) plays a key role in neural repair and may modulate oxidative stress responses. However, the relationship between ApoE expression at different stages after TBI and oxidative stress markers, as well as its association with cognitive outcomes, remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 126 patients with TBI were prospectively enrolled and stratified according to the Glasgow Coma Scale (GCS) score on admission into mild (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f60), moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f41), and severe groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f25). Peripheral blood samples were collected at 12\u202fh, 24\u202fh, and 3\u202fdays after admission to measure serum levels of ApoE, glutathione (GSH), and malondialdehyde (MDA). Cognitive function was assessed prior to discharge using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Serum ApoE levels peaked at 24\u202fh and slightly decreased thereafter, with overall levels increasing in proportion to TBI severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). GSH levels progressively decreased, whereas MDA levels increased, with significant differences among the three groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Pre-discharge LOTCA scores were highest in the mild group and lowest in the severe group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Spearman correlation analysis revealed that ApoE levels were negatively correlated with GSH (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.6712) and positively correlated with MDA (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.6934) and LOTCA scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.7382) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ApoE exhibits an injury-severity-dependent increase during the early stage of TBI, and its levels are closely associated with oxidative stress imbalance and cognitive impairment. These findings suggest that ApoE may play a critical role in both the pathological progression and neural repair following TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1692712","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:15:58Z","timestamp":1764306958000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A study on the association of apolipoprotein E with oxidative stress markers, neurological function, and cognitive impairment following traumatic brain injury"],"prefix":"10.3389","volume":"16","author":[{"given":"Haoyang","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/j.amepre.2025.01.001","article-title":"Global burden of traumatic brain injury in 204 countries and territories from 1990 to 2021","volume":"68","author":"Zhong","year":"2025","journal-title":"Am J Prev Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"380","DOI":"10.3390\/medicina60030380","article-title":"Cognitive impairment following mild traumatic brain injury (mTBI): a review","volume":"60","author":"Mavroudis","year":"2024","journal-title":"Medicina"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1326115","DOI":"10.3389\/fnbeh.2024.1326115","article-title":"Traumatic brain injuries: a neuropsychological review","volume":"18","author":"Chan","year":"2024","journal-title":"Front Behav Neurosci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0300910","DOI":"10.1371\/journal.pone.0300910","article-title":"Prevalence of fatigue and cognitive impairment after traumatic brain injury","volume":"19","author":"Wright","year":"2024","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3858","DOI":"10.3390\/ijms26083858","article-title":"Potential correlation between molecular biomarkers and oxidative stress in traumatic brain injury","volume":"26","author":"Ionescu","year":"2025","journal-title":"Int J Mol Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"960741","DOI":"10.3389\/fneur.2022.960741","article-title":"Examining four blood biomarkers for the detection of acute intracranial abnormalities following mild traumatic brain injury in older adults","volume":"13","author":"Iverson","year":"2022","journal-title":"Front Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"105644","DOI":"10.1016\/j.msard.2024.105644","article-title":"Evaluating the utility of serum NfL, GFAP, UCHL1 and tTAU as estimates of CSF levels and diagnostic instrument in neuroinflammation and multiple sclerosis","volume":"87","author":"Koerbel","year":"2024","journal-title":"Mult Scler Relat Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"13000","DOI":"10.3390\/ijms232113000","article-title":"Oxidative stress in traumatic brain injury","volume":"23","author":"Fesharaki-Zadeh","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1007\/s13311-023-01413-0","article-title":"ApoE mimetic peptides as therapy for traumatic brain injury","volume":"20","author":"Laskowitz","year":"2023","journal-title":"Neurotherapeutics"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/s13054-023-04538-y","article-title":"Cerebral apolipoprotein E and amyloid precursor-like protein 1 as risk factors for chronic neurodegeneration after non-traumatic acute brain injury (ABI)","volume":"27","author":"Santacruz","year":"2023","journal-title":"Crit Care"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.4103\/NRR.NRR-D-24-01274","article-title":"Neuropsychiatric symptoms and apolipoprotein E genotypes in neurocognitive disorders","volume":"21","author":"Lozupone","year":"2026","journal-title":"Neural Regen Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"446","DOI":"10.3389\/fneur.2019.00446","article-title":"Blood biomarkers for traumatic brain injury: a quantitative assessment of diagnostic and prognostic accuracy","volume":"10","author":"Gan","year":"2019","journal-title":"Front Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/s0140-6736(74)91639-0","article-title":"Assessment of coma and impaired consciousness. 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