J Korean Neurosurg Soc.  2015 Aug;58(2):93-100. 10.3340/jkns.2015.58.2.93.

A Role of Serum-Based Neuronal and Glial Markers as Potential Predictors for Distinguishing Severity and Related Outcomes in Traumatic Brain Injury

• Lee JY
• Lee CY
• Kim HR
• Lee CH
• Kim HW
• Kim JH

• KMID: 2191315
• DOI: http://doi.org/10.3340/jkns.2015.58.2.93

Abstract

OBJECTIVE
Optimal treatment decision and estimation of the prognosis in traumatic brain injury (TBI) is currently based on demographic and clinical predictors. But sometimes, there are limitations in these factors. In this study, we analyzed three central nervous system biomarkers in TBI patients, will discuss the roles and clinical applications of biomarkers in TBI.
METHODS
From July on 2013 to August on 2014, a total of 45 patients were included. The serum was obtained at the time of hospital admission, and biomarkers were extracted with centrifugal process. It was analyzed for the level of S-100 beta (S100B), glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1).
RESULTS
This study included 33 males and 12 females with a mean age of 58.5 (19-84) years. TBI patients were classified into two groups. Group A was severe TBI with Glasgow Coma Scale (GCS) score 3-5 and Group B was mild TBI with GCS score 13-15. The median serum concentration of S100B, GFAP, and UCH-L1 in severe TBI were raised 5.1 fold, 5.5 fold, and 439.1 fold compared to mild injury, respectively. The serum levels of these markers correlated significantly with the injury severity and clinical outcome (p<0.001). Increased level of markers was strongly predicted poor outcomes.
CONCLUSION
S100B, GFAP, and UCH-L1 serum level of were significantly increased in TBI according to severity and associated clinical outcomes. Biomarkers have potential utility as diagnostic, prognostic, and therapeutic adjuncts in the setting of TBI.

Keyword

Brain injuries; Biological markers; S100 Calcium Binding Protein beta Subunit; Glial fibrillary acidic protein; Ubiquitin thiolesterase

MeSH Terms

Biomarkers
Brain Injuries*
Central Nervous System
Female
Glasgow Coma Scale
Glial Fibrillary Acidic Protein
Humans
Male
Neurons*
Prognosis
S100 Calcium Binding Protein beta Subunit
Ubiquitin
Ubiquitin Thiolesterase
Glial Fibrillary Acidic Protein
Ubiquitin
Ubiquitin Thiolesterase

Figure

• 

  Fig. 1 Distribution of GCS score of S100B (A), GFAP (B), and UCH-L1 (C). GCS : Glasgow Coma Scale, S100B : S-100 beta, GFAP : glial fibrillary acidic protein, UCH-L1 : ubiquitin carboxy-terminal hydrolase-L1.

• 

  Fig. 2 Mean serum concentrations of biomarkers in each groups (severe/mild injured). S100B : S-100 beta, GFAP : glial fibrillary acidic protein, UCH-L1 : ubiquitin C-terminal hydrolase-L1.

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  Fig. 3 Mean serum concentration of biomarkers in each groups (death/survivor). S100B : S-100 beta, GFAP : glial fibrillary acidic protein, UCH-L1 : ubiquitin C-terminal hydrolase-L1.

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  Fig. 4 Scatter plot of correlation between S100B and GFAP (A), UCH-L1 and S100B (B), and UCH-L1 and GFAP (C). S100B : S-100 beta, GFAP : glial fibrillary acidic protein, UCH-L1 : ubiquitin C-terminal hydrolase-L1.

• 

  Fig. 5 Receiver operating characteristic curves of the biomarkers. S100B : S-100 beta, GFAP : glial fibrillary acidic protein, UCH-L1 : ubiquitin C-terminal hydrolase-L1.

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