Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury

Abstract

These results suggest that determination of serum levels of glial and neuronal proteins may add to the clinical assessment of the primary damage and prediction of outcome after severe traumatic brain injury.

Biomarkers for the Diagnosis, Prognosis, and Evaluation of Treatment Efficacy for Traumatic Brain Injury

“…For example, GFAP serum concentrations Ͼ1.5 ng/mL were found to be predictive of death (85% sensitivity; 52% specificity) or poor outcome (GOS at 6 months; 80% sensitivity; 59% specificity). 15 Consistent with its brain-specific expression, GFAP levels were found to be normal in multitrauma patients that did not have brain injury. 24 …”

“…Increased levels of this protein have been proposed as biomarkers of poor outcome. For example, Vos et al 15 demonstrated that in patients with severe TBI, serum S100B concentrations Ͼ1.13 ng/mL were associated with increased mortality (100% sensitivity; 41% specificity) and morbidity (88% sensitivity; 43% specificity). The low basal levels of S100B in human serum allow increases in the concentrations of this protein to be very sensitive indicators of brain injury.…”

“…It is a brain-specific protein that is released after TBI. 15,[22][23][24] Increases in serum GFAP levels after TBI have been shown to be predictive of elevated intracranial pressure (ICP), reduced mean arterial pressure, low cerebral perfusion pressure, poor Glasgow outcome scores (GOS), and increased mortality. For example, GFAP serum concentrations Ͼ1.5 ng/mL were found to be predictive of death (85% sensitivity; 52% specificity) or poor outcome (GOS at 6 months; 80% sensitivity; 59% specificity).…”

“…However, inadequate sensitivity and specificity have limited the use of NSE regarding the neuropsychological outcome (55% sensitivity; 77.8% specificity) and predicting the presence of intracranial lesions (77% sensitivity; 52% specificity). 15,28,29 Used in isolation, elevated serum NSE levels do not necessarily indicate the presence of brain trauma, as this protein has also been suggested to be a marker for small cell lung cancer, neuroendocrine bladder tumors, ischemic stroke, and neuroblastomas.…”

Biomarcadores prognósticos no traumatismo crânio-encefálico grave

“…(16) In severe TBI, S100B correlates with a short time outcome (death or survival), functional prognosis in 6 months and with severity criteria of TBI such as the Marshall score and the ISS. (15,23,24) Serum levels of S100B, assessed in the first hours after severe TBI have been better predictors of long term prognosis, when assessed by the GOS scale than the GCS and the CT Marshall scale. (25) Because S100B has a halflife of about 2 hours, increased values due to primary brain damage should return to baseline levels in 12 to 24 hours.…”