Comparison of caspase-8, granzyme B and cytochrome C apoptosis biomarker levels in orthopedic trauma patients

Ulus Travma Acil Cerrahi Derg. 2020 Mar;26(2):274-279. doi: 10.14744/tjtes.2019.02680.


Background: The primary objective of this study was to investigate whether or not apoptosis is induced following bone fracture, and if so, to investigate whether the extrinsic or intrinsic pathway of cell death is stimulated.

Methods: A total of 30 patients who presented at our clinic and were diagnosed with bone fracture following trauma were included in the study group. A control group was formed of 37 age and gender-matched volunteers. On the day after the fracture, blood samples taken from the patients were examined for cytochrome C, granzyme B and caspase-8 with the ELISA method.

Results: A total of 67 individuals were evaluated (fracture group: 30, control group: 37) in this study. Caspase-8 was found to be statistically significantly high in the patient group (0.37±0.06 ng/mL, p=0.002). No significant difference was determined between the groups in respect to cytochrome C values (p=0.173). The granzyme B values were determined to be significantly high in the patient group (52.56±8.51 pg/mL, p=0.007).

Conclusion: These results obtained from patients with a long bone fracture demonstrated that serum caspase-8 and granzyme B levels were higher in patients than in the control group, thereby showing activation of the extrinsic pathway. However, no significant difference was determined between the groups concerning serum cytochrome C levels. This study may guide future studies designed for better understanding of the molecular pathways that govern the events during a fracture, which will be important for the future advancement of fracture treatment.

MeSH terms

  • Apoptosis / physiology*
  • Biomarkers
  • Case-Control Studies
  • Caspase 8 / blood*
  • Cytochromes c / blood*
  • Fractures, Bone* / blood
  • Fractures, Bone* / epidemiology
  • Granzymes / blood*
  • Humans


  • Biomarkers
  • Cytochromes c
  • GZMB protein, human
  • Granzymes
  • Caspase 8