Utility of biomarkers in traumatic brain injury: a narrative review

Abstract

Introduction: With the evolution of diagnostic techniques in traumatic brain injury (TBI), the study of neurological injury has made progress based on the concepts of primary and secondary injury, leading to the era of proteomics to understand the complex molecular events involved in the process.
 Objectives: This narrative review is intended to discuss the state of the art of the most frequently used biomarkers in TBI, their clinical utility, and the implications for therapeutic decisionmaking protocols.
 Materials and methods: In order to fulfill the objective of this paper, a literature review was conducted of the most important databases.
 Results: Several biomarkers have been studied as prognostic factors in patients with TBI. Learning about their sensitivity and specificity in neurological injury, and its post-trauma evolution over time, has been the goal of various papers in the past few years.
 Conclusion: Breakthroughs in the study of protein degradation make it necessary to broaden the spectrumand knowledge of new diagnostic methods in TBI. Further studies are needed to define the role of biomarkers and to promote protocols integrating specific values.

Clinical Theragnostic Signature of Extracellular Vesicles in Traumatic Brain Injury (TBI)

“…77 GFAP protein increases after a TBI, increasing the astroglia's support, movement, form, and function. 9 Also, GFAP may be used as a marker to distinguish MRI-positive TBI patients without CT findings from patients with negative MRI and CT. 80 Even if these observations were from preparations of entire exosomes or EVs, it might be inferred that these signals originated from ADEs (astrocyte-derived exosomes) because GFAP is only generated in the cytoplasm of astrocytes. 73 According to numerous studies, TBI is frequently associated with the marker amyloid beta 42 (Aβ42), and Aβ42 is enhanced in isolated exosomes or extracellular vesicles.…”

“…GFAP protein increases after a TBI, increasing the astroglia’s support, movement, form, and function . Also, GFAP may be used as a marker to distinguish MRI-positive TBI patients without CT findings from patients with negative MRI and CT .…”

“…The most recent recommendation from the National Academies of Sciences, Engineering, and Medicine for TBI reporting has modified the classification strategy. Now this process is reported directly based on a Glasgow Coma Scale scores. − Additionally, increasing evidence suggests moderate-to-severe or recurrent mild TBI (mTBI) may increase Alzheimer’s disease risk ,, and chronic traumatic encephalopathy . Mild TBI, such as concussions, accounts for the majority of TBIs.…”

Serum Zinc and Long-Term Prognosis after Acute Traumatic Brain Injury with Intracranial Injury: A Multicenter Prospective Study

“…A large medical and economic burden over a long period of time also has a large social impact [ 2 , 3 ]. Accurate predictive models for the diagnosis and prognosis of intracranial injury have been necessary for an effective therapeutic strategy to improve clinical outcomes and decrease disease burden of TBI [ 4 ]. There have been many approaches to finding cellular and biochemical biomarkers predicting the prognosis of TBI [ 5 , 6 ].…”

Biomarkers of Neuroinflammation in Traumatic Brain Injury

“…Moreover, biomarkers function as a surrogate to aid in our understanding of neuroinflammation within the brain to monitor for changes in the biochemical and inflammatory signatures as the brain recovers, to predict the likelihood for life long sequalae from the injury, and to correlate with functional and cognitive outcomes. Although there are other reviews examining biomarkers in TBI (Dadas et al, 2018; Edalatfar et al, 2021; Hier et al, 2021; Mendoza et al, 2020; Toman et al, 2016; Visser et al, 2022), many of these reviews focus solely on a specific diagnosis (e.g., concussion), or focus solely on a select few biomarkers, primarily those that have been most extensively studied. This systematic review is unique in that it provides a comprehensive review of biomarkers in humans with a TBI.…”