A Serum Protein Biomarker Panel Improves Outcome Prediction in Human Traumatic Brain Injury

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A Serum Protein Biomarker Panel Improves Outcome Prediction in Human Traumatic Brain Injury

Thelin, E. (author): Karolinska Institutet

Al Nimer, F. (author): Karolinska Institutet

Frostell, A. (author)

Zetterberg, Henrik, 1973 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry

Blennow, Kaj, 1958 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry

Nystrom, H. (author)

Svensson, M. (author): Karolinska Institutet

Bellander, B. M. (author): Karolinska Institutet

Piehl, F. (author): Karolinska Institutet

Nelson, D. W. (author): Karolinska Institutet

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Mary Ann Liebert Inc, 2019
2019
English.
In: Journal of Neurotrauma. - : Mary Ann Liebert Inc. - 0897-7151 .- 1557-9042.

Related links:: https://www.liebertp...; show more...; https://gup.ub.gu.se...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Brain-enriched protein biomarkers of tissue fate are being introduced clinically to aid in traumatic brain injury (TBI) management. The aim of this study was to determine how concentrations of six different protein biomarkers, measured in samples collected during the first weeks after TBI, relate to injury severity and outcome. We included neurocritical care TBI patients that were prospectively enrolled from 2007 to 2013, all having one to three blood samples drawn during the first 2 weeks. The biomarkers analyzed were S100 calcium-binding protein B (S100B), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), tau, and neurofilament-light (NF-L). Glasgow Outcome Score (GOS) was assessed at 12 months. In total, 172 patients were included. All serum markers were associated with injury severity as classified on computed tomography scans at admission. Almost all biomarkers outperformed other known outcome predictors with higher levels the first 5 days, correlating with unfavorable outcomes, and UCH-L1 (0.260, pseduo-R-2) displaying the best discrimination in univariate analyses. After adjusting for acknowledged TBI outcome predictors, GFAP and NF-L added most independent information to predict favorable/unfavorable GOS, improving the model from 0.38 to 0.51 pseudo-R-2. A correlation matrix indicated substantial covariance, with the strongest correlation between UCH-L1, GFAP, and tau (r = 0.827-0.880). Additionally, the principal component analysis exhibited clustering of UCH-L1 and tau, as well as GFAP, S100B, and NSE, which was separate from NF-L. In summary, a panel of several different protein biomarkers, all associated with injury severity, with different cellular origin and temporal trajectories, improve outcome prediction models.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)

Keyword

functional outcome
injury severity assessment
neuroradiology
protein biomarkers
serum analysis
fibrillary acidic protein
c-terminal hydrolase-l1
neuron-specific
enolase
neurofilament light protein
s-100b protein
prognostic
analysis
plasma-levels
tau proteins
s100b
blood
General & Internal Medicine
Neurosciences & Neurology

Publication and Content Type

ref (subject category)
art (subject category)

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By the author/editor: Thelin, E.; Al Nimer, F.; Frostell, A.; Zetterberg, Henr ...; Blennow, Kaj, 19 ...; Nystrom, H.; show more...; Svensson, M.; Bellander, B. M.; Piehl, F.; Nelson, D. W.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Neurosciences

Articles in the publication: Journal of Neuro ...

By the university: University of Gothenburg; Karolinska Institutet

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