Association of day-of-injury plasma glial fibrillary acidic protein concentration and six-month posttraumatic stress disorder in patients with mild traumatic brain injury

Kulbe, Jacqueline R.; Jain, Sonia; Nelson, Lindsay D.; Korley, Frederick K.; Mukherjee, Pratik; Sun, Xiaoying; Okonkwo, David O.; Giacino, Joseph T.; Vassar, Mary J.; Robertson, Claudia S.; McCrea, Michael; Wang, Kevin; Temkin, Nancy; Donald, Christine L. Mac; Taylor, Sabrina R; Ferguson, Adam R.; Markowitz, Amy J.; Manley, Geoffrey T.; Stein, Murray B.

doi:10.1038/s41386-022-01359-5

Cited by 12 publications

(4 citation statements)

References 43 publications

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“…Moreover, it has also been reported that levels of GFAP are elevated in individuals with PTSD. However, the findings are not consistent across studies, and more research is needed to establish a clear and reliable connection [15,16]. To investigate this issue, we examined GFAP levels in a pilot cohort who were diagnosed with PTSD and taking SSRIs and determined GFAP levels in individuals who were prescribed an SSRI irrespective of their PTSD diagnosis.…”

Section: Gfap Levels Across Control and Ptsd Individuals And Individu...mentioning

confidence: 99%

Serum Glial Fibrillary Acidic Protein (GFAP) Levels Are Higher in Individuals Taking Selective Serotonin Reuptake Inhibitors (SSRIs)

Mary Jo,

Joanne,

Paul

et al. 2024

Int J Brain Disord Treat

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Introduction: PTSD is a mental health condition that can develop in some individuals who have experienced or witnessed a traumatic or life-threatening event. Previously, we identified a combination of blood biomarkers to differentiate controls from a PTSD cohort. This biomarker model could be used to diagnose and monitor treatment of PTSD, both behavioural and pharmacological. A recent publication questioned the health impact of selective serotonin reuptake inhibitors (SSRIs) which are used to improve mood, emotion and cognition and treat PTSD, and that long-term use of antidepressants may decrease serotonin levels. The action of SSRIs may potentially impact astrocytes and damaged astrocytes release GFAP into the bloodstream. In our previous study, GFAP did not contribute to the model. The aim of the current study was to revisit the previous data and to determine whether there were differences in GFAP levels between control and PTSD individuals and to determine levels of serum GFAP in individuals prescribed SSRIs.

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Section: Gfap Levels Across Control and Ptsd Individuals And Individu...mentioning

confidence: 99%

Serum Glial Fibrillary Acidic Protein (GFAP) Levels Are Higher in Individuals Taking Selective Serotonin Reuptake Inhibitors (SSRIs)

Mary Jo,

Joanne,

Paul

et al. 2024

Int J Brain Disord Treat

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“…Risks for post-traumatic stress disorder (PTSD), depression, and other mental diseases increase dramatically after a TBI (Barnes et al, 2018 ; Roy et al, 2019 ; Stein et al, 2019 ; Kulbe et al, 2022 ). Patients dealing with TBIs' long-term effects are often at the risk of developing cognitive impairment (CI) or post-concussion syndrome (PCS) (Mehrolhassani et al, 2020 ).…”

Section: Evs As Potential Predictors Of Functional Outcomes In Tbimentioning

confidence: 99%

The evolving role of extracellular vesicles (exosomes) as biomarkers in traumatic brain injury: Clinical perspectives and therapeutic implications

Khan

Asim²,

El‐Menyar³

et al. 2022

Front. Aging Neurosci.

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Developing effective disease-modifying therapies for neurodegenerative diseases (NDs) requires reliable diagnostic, disease activity, and progression indicators. While desirable, identifying biomarkers for NDs can be difficult because of the complex cytoarchitecture of the brain and the distinct cell subsets seen in different parts of the central nervous system (CNS). Extracellular vesicles (EVs) are heterogeneous, cell-derived, membrane-bound vesicles involved in the intercellular communication and transport of cell-specific cargos, such as proteins, Ribonucleic acid (RNA), and lipids. The types of EVs include exosomes, microvesicles, and apoptotic bodies based on their size and origin of biogenesis. A growing body of evidence suggests that intercellular communication mediated through EVs is responsible for disseminating important proteins implicated in the progression of traumatic brain injury (TBI) and other NDs. Some studies showed that TBI is a risk factor for different NDs. In terms of therapeutic potential, EVs outperform the alternative synthetic drug delivery methods because they can transverse the blood–brain barrier (BBB) without inducing immunogenicity, impacting neuroinflammation, immunological responses, and prolonged bio-distribution. Furthermore, EV production varies across different cell types and represents intracellular processes. Moreover, proteomic markers, which can represent a variety of pathological processes, such as cellular damage or neuroinflammation, have been frequently studied in neurotrauma research. However, proteomic blood-based biomarkers have short half-lives as they are easily susceptible to degradation. EV-based biomarkers for TBI may represent the complex genetic and neurometabolic abnormalities that occur post-TBI. These biomarkers are not caught by proteomics, less susceptible to degradation and hence more reflective of these modifications (cellular damage and neuroinflammation). In the current narrative and comprehensive review, we sought to discuss the contemporary knowledge and better understanding the EV-based research in TBI, and thus its applications in modern medicine. These applications include the utilization of circulating EVs as biomarkers for diagnosis, developments of EV-based therapies, and managing their associated challenges and opportunities.

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“… 7 , 8 In fact, several studies have shown that GFAP concentration is related to prognostic factors of TBI patients such as GCS, lactate, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Rotterdam score, SAPS II score. 9 , 10 During the treatment process of TBI patients, GFAP levels and some prognostic factors such as GCS, lactate, APACHE II score, Rotterdam score, and SAPS II score all change regularly. Furthermore, these indicators indirectly reflect severity or better improvement.…”

Section: Introductionmentioning

confidence: 99%

Changes in the levels of serum glial fibrillary acidic protein and the correlation with outcomes in severe traumatic brain injury patients

Trung Nguyen,

Dinh Le,

Dang Le

et al. 2024

SAGE Open Medicine

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Purpose: Glial fibrillary acidic protein serves as a biomarker indicative of astroglial injury, particularly following instances of severe traumatic brain injury. This study aims to evaluate variations in serum glial fibrillary acidic protein levels within the first 3 days and their correlation with outcomes in patients with severe traumatic brain injury. Subjects and methods: Thirty-nine patients with severe traumatic brain injury were enrolled in the study. Their blood samples were collected at six distinct time points: T0 (upon admission), T1, T2, T3, T4, and T5 (6-, 12-, 24-, 48-, and 72-h post-admission, respectively). The blood samples were run for the quantification of serum glial fibrillary acidic protein levels and other biochemical tests. All patients were closely watched and the outcomes at discharge were evaluated. Results: Glial fibrillary acidic protein levels tend to increase gradually from the time of admission to 48 h post-admission and then decrease at 72 h post-admission. Glial fibrillary acidic protein T2 is correlated with Acute Physiology and Chronic Health Evaluation II score, lactate, Simplified Acute Physiology Score II score and outcome. Glial fibrillary acidic protein max correlated with lactate, Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II score, and outcome. Glasgow Coma Score at admission and glial fibrillary acidic protein T2 (OR = 1.034; p = 0.025), T3 (OR = 1.029; p = 0.046), T4 (OR = 1.006; p = 0.032), T5 (OR = 1.012; p = 0.048) and glial fibrillary acidic protein max (OR = 1.005; p = 0.010) were independent factors that have significant prognostic value in mortality in patients with severe traumatic brain injury. The predictive model in predicting mortality had the highest area under the curve based on glial fibrillary acidic protein T2 and Glasgow Coma Score T0 with an area under the curve of 0.904 and p < 0.001. In the multivariable regression model, glial fibrillary acidic protein max was associated with Glasgow score ( p < 0.001; VIF = 1.585), lactate T0 ( p = 0.024; VIF = 1.163), Acute Physiology and Chronic Health Evaluation II score ( p = 0.037; VIF = 1.360), and Rotterdam score ( p = 0.044; VIF = 1.713). Conclusion: Glial fibrillary acidic protein levels tend to increase gradually from the time of admission to 48 h post-admission then decreases at 72 h post-admission. Glial fibrillary acidic protein T2, T3, T4, T5, and glial fibrillary acidic protein max were independent factors with significant prognostic mortality values in patients with severe traumatic brain injury.

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Association of day-of-injury plasma glial fibrillary acidic protein concentration and six-month posttraumatic stress disorder in patients with mild traumatic brain injury

Cited by 12 publications

References 43 publications

Serum Glial Fibrillary Acidic Protein (GFAP) Levels Are Higher in Individuals Taking Selective Serotonin Reuptake Inhibitors (SSRIs)

Serum Glial Fibrillary Acidic Protein (GFAP) Levels Are Higher in Individuals Taking Selective Serotonin Reuptake Inhibitors (SSRIs)

The evolving role of extracellular vesicles (exosomes) as biomarkers in traumatic brain injury: Clinical perspectives and therapeutic implications

Changes in the levels of serum glial fibrillary acidic protein and the correlation with outcomes in severe traumatic brain injury patients

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