Ubiquitin carboxyl-terminal esterase L1 is not elevated in the serum of concussed rugby players: an observational cross-sectional study

Abstract

Concussion diagnosis is complicated by a lack of objective measures. Ubiquitin carboxyl-terminal esterase L1 (UCHL1) is a biomarker that has been shown to increase following traumatic brain injury but has not been investigated in concussed athletes on the sideline of athletic events. Therefore, this study was conducted to determine if UCHL1 can be used to aid in sideline concussion diagnosis. Blood was taken via standard venipuncture from a recreationally active control group, a group of rugby players prior to match play (pre-match), rugby players following match-play (match-control), and rugby players after suffering a sport-related concussion (SRC). UCHL1 was not significantly different among groups (p > 0.05) and was unable to distinguish between SRC and controls (AUROC < 0.400, p > 0.05). However, when sex-matched data were used, it was found that the female match-control group had a significantly higher serum UCHL1 concentration than the pre-match group (p = 0.041). Differences were also found in serum UCHL1 concentrations between male and female athletes in the match-control group (p = 0.007). This study does not provide evidence supporting the use of UCHL1 in sideline concussion diagnosis when blood is collected soon after concussion but does show differences in serum UCHL1 accumulation between males and females.

Plasma UCHL1, GFAP, Tau, and NfL Are Not Different in Young Healthy Persons With Mild COVID-19 Symptoms Early in the Pandemic: A Pilot Study

“…Our study found sex differences in plasma biomarker concentrations when female data from the SARS-CoV-2-positive and SARS-CoV-2-naïve groups were combined and compared to male data, with females having lower UCHL1 and NfL levels but higher tau levels than males. In agreement with our study, lower levels of serum UCHL1 in females compared with males have been found previously, 40 , 42 along with no sex differences for GFAP. 42 In contradiction to our findings, previous research has not found sex differences for serum tau.…”

“…We included analysis of plasma UCHL1 in our study because UCHL1 has been shown to indicate moderate TBI 39 and has been found to be elevated in COVID-19 intensive care unit (ICU) patients, 31 although UCHL1 has been less successful in distinguishing mild TBI. 40 , 41 Despite this, UCHL1 was the only plasma biomarker that showed significant differences among visits within the SARS-CoV-2-positive participants, with plasma UCHL1 concentration at visit 3 being significantly greater than UCHL1 concentrations at visits 1 and 2. This is a unique finding given that our study is the first to investigate plasma UCHL1 in a cohort of participants infected with SARS-CoV-2 exhibiting only mild symptoms.…”

Sex differences in time course and diagnostic accuracy of GFAP and UCH-L1 in trauma patients with mild traumatic brain injury

“…Therefore, it may be inherently higher in male patients. There are a few studies in the sports literature that have found that male athletes have higher baseline serum UCH-L1 concentrations than female athletes 19 , 20 . These findings could have implications for adjusting cut-off points for diagnostic tests currently developed or in development.…”