Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)

Potential of heart fatty-acid binding protein, neurofilament light, interleukin-10 and S100 calcium-binding protein B in the acute diagnostics and severity assessment of traumatic brain injury




Julkaisun tekijät: Koivikko Pia, Posti Jussi P., Mohammadian Mehrbod, Lagerstedt Linnea, Azurmendi Leire, Hossain Iftakher, Katila Ari J., Menon David, Newcombe Virginia F. J., Hutchinson Peter John, Maanpaa Henna-Riikka, Tallus Jussi, Zetterberg Henrik, Blennow Kaj, Tenovuo Olli, Sanchez Jean-Charles, Takala Riikka S. K.

Kustantaja: BMJ PUBLISHING GROUP

Julkaisuvuosi: 2021

Journal: Emergency Medicine Journal

Tietokannassa oleva lehden nimi: EMERGENCY MEDICINE JOURNAL

Lehden akronyymi: EMERG MED J

Sivujen määrä: 7

ISSN: 1472-0205

eISSN: 1472-0213

DOI: http://dx.doi.org/10.1136/emermed-2020-209471

Verkko-osoite: https://emj.bmj.com/content/early/2021/12/15/emermed-2020-209471

Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/68687540


Tiivistelmä

Background: There is substantial interest in blood biomarkers as fast and objective diagnostic tools for traumatic brain injury (TBI) in the acute setting.

Methods: Adult patients (≥18) with TBI of any severity and indications for CT scanning and orthopaedic injury controls were prospectively recruited during 2011-2013 at Turku University Hospital, Finland. The severity of TBI was classified with GCS: GCS 13-15 was classified as mild (mTBI); GCS 9-12 as moderate (moTBI) and GCS 3-8 as severe (sTBI). Serum samples were collected within 24 hours of admission and biomarker levels analysed with high-performance kits. The ability of biomarkers to distinguish between severity of TBI and CT-positive and CT-negative patients was assessed.

Results: Among 189 patients recruited, neurofilament light (NF-L) was obtained from 175 patients with TBI and 40 controls. S100 calcium-binding protein B (S100B), heart fatty-acid binding protein (H-FABP) and interleukin-10 (IL-10) were analysed for 184 patients with TBI and 39 controls. There were statistically significant differences between levels of all biomarkers between the severity classes, but none of the biomarkers distinguished patients with moTBI from patients with sTBI. Patients with mTBI discharged from the ED had lower levels of IL-10 (0.26, IQR=0.21, 0.39 pg/mL), H-FABP (4.15, IQR=2.72, 5.83 ng/mL) and NF-L (8.6, IQR=6.35, 15.98 pg/mL) compared with those admitted to the neurosurgical ward, IL-10 (0.55, IQR=0.31, 1.42 pg/mL), H-FABP (6.022, IQR=4.19, 20.72 ng/mL) and NF-L (13.95, IQR=8.33, 19.93 pg/mL). We observed higher levels of H-FABP and NF-L in older patients with mTBI. None of the biomarkers or their combinations was able to distinguish CT-positive (n=36) or CT-negative (n=58) patients with mTBI from controls.

Conclusions: S100B, H-FABP, NF-L and IL-10 levels in patients with mTBI were significantly lower than in patients with moTBI and sTBI but alone or in combination, were unable to distinguish patients with mTBI from orthopaedic controls. This suggests these biomarkers cannot be used alone to diagnose mTBI in trauma patients in the acute setting.


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Last updated on 2022-07-04 at 16:21