Fresh Frozen Plasma Attenuates Circulating Nucleosome Levels and DNASe1 Depletion Following Traumatic Brain Injury and Shock

Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of morbidity and mortality in trauma. Recently, circulating nucleosomes have been shown to increase the brain lesion size through the cytotoxic properties of histones, a core constituent of nucleosomes. We have previously reported that Fresh Frozen Plasma (FFP) resuscitation reduce lesion size and brain swelling compared with normal saline (NS) in a combined model of TBI+HS. We hypothesize that this effect is associated with an attenuation of circulating nucleosome levels through increased deoxyribonuclease1 (DNAse1), a principal player in nucleosome removal from the circulation.