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.
References
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2. Stenberg M, Koskinen LD, Jonasson P, et al. Computed tomography and clinical outcome in patients with severe traumatic brain injury. Brain Inj 2017;31:351–358.
3. Roh D, Park S. Brain multimodality monitoring: updated perspectives. Curr Neurol Neurosci Rep 2016;16:56.
4. Smith M. Multimodality neuromonitoring in adult traumatic brain injury: a narrative review. Anesthesiology 2018;128:401–415.
5. Nordstrom CH. Cerebral microdyalisis in TBI: limitations and possibilities. Acta Neurochir (Wien) 2017;159:2275–2277.
6. Bazarian JJ, Biberthaler P, Welch R, et al. Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): a multicentre observational study. Lancet Neurol 2018;17:782–789.
7. Lagerstedt L, Egea-Guerrero JJ, Bustamante A, et al. Combining HFABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury. PLoS One 2018;13:e0200394.
8. Papa L, Zonfrillo M, Ramírez J, et al. Performance of glial fibrillary acidic protein (GFAP) in detecting traumatic intracranial lesions on computed tomography in children and youth with mild head trauma. Acad Emerg Med 2015;22:1274–1282.
9. Vos PE. Biomarkers of focal and diffuse traumatic brain injury. Crit Care 2011;15:183.
10. Thelin EP, Nelson DW, Bellander BM. A review of the clinical utility of serum S100B protein levels. Acta Neurochir 2016;159:209–225.
11. Thelin EP, Zeiler FA, Ercole A, et al. Serial sampling of serum protein biomarkers for monitoring human traumatic brain injury dynamics. Front Neurol 2017;8:3000.
12. Unden J, Ingebrigtsen T, Romner B, et al. Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults: an evidence and consensus-based update. BMC Med 2013;11:50.
13. Olivecrona Z, Koskinen L-OD. The release of S-100B and NSE in severe traumatic head injury is associated with APOE e4. Acta Neurochirurgica 2012;154:675–680.
14. Gordillo-Escobar E, Egea-Guerrero JJ, Rodríguez-Rodríguez A, et al. Usefulness of biomarkers in the prognosis of severe traumatic brain injury. Med Intensiva 2016;40:105–112.
15. Muneer PMA, Chandra N, Haorah J. Interactions of oxidative stress and neurovascular inflammation in the pathogenesis of traumatic brain injury. Mol Neurobiol 2015;51:966–979.
16. Woodcock T, Morganti-Kossmann MC. The role of markers of inflammation in traumatic brain injury. Front Neurol 2013;4:18.
17. Czeiter E, Mondello S, Kovacs N, et al. Brain injury biomarkers may improve the predictive power of the impact outcome calculator. J Neurotrauma 2012;29:1770–1778.
18. Takala RSK, Posti JP, Runtti H, et al. Glial fibrillary acidic protein and ubiquitin c-terminal hydrolase-L1 as outcome predictors in traumatic brain injury. World Neurosurg 2016;87:8–20.
19. Olczak M, Niderla-Bielinska J, Kwiatkowska M, et al. Tau protein (MAPT) as a possible biochemical marker of traumatic brain injury in postmortem examination. Forensic Sci Int 2017; 280:1–7.
20. Manivannan S, Makwana M, Ahmed AI, et al. Profiling biomarkers of traumatic axonal injury: from mouse to man. Clin Neurol Neurosurg 2018;171:6–20.
21. McCracken E, Hunter AJ, Patel S, et al. Calpain activation and cytoskeletal protein breakdown in the corpus callosum of headinjured patients. J Neurotrauma 1999;16:749–6110.
22. Wang KK, Yang Z, Zhu T, et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury. Expert Rev Molecular Diagn 2018;18:165–180.
23. Kellermann I, Kleindienst A, Hore N, et al. Early CSF and serum S100B concentrations for outcome prediction in traumatic brain injury and subarachnoid hemorrhage. Clin Neurol Neurosurg 2016;145:79–83.
24. Díaz-Arrastia R, Wang KKW, Papa L, et al. Acute biomarkers of traumatic brain injury: relationship between plasma levels of ubiquitin c-terminal hydrolase-L1 and glial fibrillary acidic protein. J Neurotrauma 2014;31:19–25.
25. Papa L, Robertson CS, Wang KKW, et al. Biomarkers improve clinical outcome predictors of mortality following non-penetrating severe traumatic brain injury. Neurocrit Care 2014;22:52–64.
26. Espiga R, Vicente J, Poncela M, et al. Usefulness of determining serum S-100b protein expression in screening patients with minor head injury in a hospital emergency department. Emergencias 2011;23:15–21.
27. Ramezani F, Bahrami-Amiri A, Babahajian A, et al. Ubiquitin C-terminal hydrolase-L1 (UCHL1) in prediction of computed tomography findings in traumatic brain injury; a meta-analysis. Emergency 2018;6:e62.
28. Papa L, Silvestri S, Brophy GM, et al. GFAP Out-Performs S100b in detecting traumatic intracranial lesions on computed tomography in trauma patientswith mild traumatic brain injury and those with extracranial lesions. J Neurotrauma 2014;31:1815–1822.
29. Business Wire a Berkshire Hathaway CompanyFDA grants marketing authorization to banyan biomarkers for the first diagnostic blood test for traumatic brain injury [Internet]. San Diego: Businesswire.com. 2018;[Cited 2020 Feb 19]. Available at: https://www.businesswire.com/news/home/20180214006251/en/FDA-Grants-Marketing-Authorization-Banyan-Biomarkers-Diagnostic.
30. Banyan BTI. Brain Trauma Indicator for in vitro diagnostic use only. Banyan Biomarkers Inc., 2018; 1–39.
31. Mondello S, Muller U, Jeromin A, et al. Blood-based diagnosis of traumatic brain injury. Expert Rev Mol Diagn 2011;11:65–78.
32. Rodríguez Sanjuán A, Cervera E, Valencia Villa G, et al. Topic review: Neural and glial biomarkers as a quantitative classification strategy for traumatic brain severity. Salud Uninorte 2016;32:302–318.
33. Sedaghat F, Notopoulos A. S100 protein family and its application in clinical practice. Hippokratia 2008;12:198–204.
34. Lewis LM, Schloemann DT, Papa L, et al. Utility of serum biomarkers in the diagnosis and stratification of mild traumatic brain injury. Acad Emerg Med 2017;24:710–720.
35. Welch REM, Lewis L, Ayaz S, et al. Modeling the kinetics of serum glial fibrillary acidic protein, ubiquitin carboxyl-terminal hydrolase-L1, and S100B concentrations in patients with traumatic brain injury. J Neurotrauma 2017;34:1957–1971.
36. Hill-Pryor CWK, Papa L, Lopez M, et al. Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury. Am Med Assoc 2016;73:551–560.
2. Stenberg M, Koskinen LD, Jonasson P, et al. Computed tomography and clinical outcome in patients with severe traumatic brain injury. Brain Inj 2017;31:351–358.
3. Roh D, Park S. Brain multimodality monitoring: updated perspectives. Curr Neurol Neurosci Rep 2016;16:56.
4. Smith M. Multimodality neuromonitoring in adult traumatic brain injury: a narrative review. Anesthesiology 2018;128:401–415.
5. Nordstrom CH. Cerebral microdyalisis in TBI: limitations and possibilities. Acta Neurochir (Wien) 2017;159:2275–2277.
6. Bazarian JJ, Biberthaler P, Welch R, et al. Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): a multicentre observational study. Lancet Neurol 2018;17:782–789.
7. Lagerstedt L, Egea-Guerrero JJ, Bustamante A, et al. Combining HFABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury. PLoS One 2018;13:e0200394.
8. Papa L, Zonfrillo M, Ramírez J, et al. Performance of glial fibrillary acidic protein (GFAP) in detecting traumatic intracranial lesions on computed tomography in children and youth with mild head trauma. Acad Emerg Med 2015;22:1274–1282.
9. Vos PE. Biomarkers of focal and diffuse traumatic brain injury. Crit Care 2011;15:183.
10. Thelin EP, Nelson DW, Bellander BM. A review of the clinical utility of serum S100B protein levels. Acta Neurochir 2016;159:209–225.
11. Thelin EP, Zeiler FA, Ercole A, et al. Serial sampling of serum protein biomarkers for monitoring human traumatic brain injury dynamics. Front Neurol 2017;8:3000.
12. Unden J, Ingebrigtsen T, Romner B, et al. Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults: an evidence and consensus-based update. BMC Med 2013;11:50.
13. Olivecrona Z, Koskinen L-OD. The release of S-100B and NSE in severe traumatic head injury is associated with APOE e4. Acta Neurochirurgica 2012;154:675–680.
14. Gordillo-Escobar E, Egea-Guerrero JJ, Rodríguez-Rodríguez A, et al. Usefulness of biomarkers in the prognosis of severe traumatic brain injury. Med Intensiva 2016;40:105–112.
15. Muneer PMA, Chandra N, Haorah J. Interactions of oxidative stress and neurovascular inflammation in the pathogenesis of traumatic brain injury. Mol Neurobiol 2015;51:966–979.
16. Woodcock T, Morganti-Kossmann MC. The role of markers of inflammation in traumatic brain injury. Front Neurol 2013;4:18.
17. Czeiter E, Mondello S, Kovacs N, et al. Brain injury biomarkers may improve the predictive power of the impact outcome calculator. J Neurotrauma 2012;29:1770–1778.
18. Takala RSK, Posti JP, Runtti H, et al. Glial fibrillary acidic protein and ubiquitin c-terminal hydrolase-L1 as outcome predictors in traumatic brain injury. World Neurosurg 2016;87:8–20.
19. Olczak M, Niderla-Bielinska J, Kwiatkowska M, et al. Tau protein (MAPT) as a possible biochemical marker of traumatic brain injury in postmortem examination. Forensic Sci Int 2017; 280:1–7.
20. Manivannan S, Makwana M, Ahmed AI, et al. Profiling biomarkers of traumatic axonal injury: from mouse to man. Clin Neurol Neurosurg 2018;171:6–20.
21. McCracken E, Hunter AJ, Patel S, et al. Calpain activation and cytoskeletal protein breakdown in the corpus callosum of headinjured patients. J Neurotrauma 1999;16:749–6110.
22. Wang KK, Yang Z, Zhu T, et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury. Expert Rev Molecular Diagn 2018;18:165–180.
23. Kellermann I, Kleindienst A, Hore N, et al. Early CSF and serum S100B concentrations for outcome prediction in traumatic brain injury and subarachnoid hemorrhage. Clin Neurol Neurosurg 2016;145:79–83.
24. Díaz-Arrastia R, Wang KKW, Papa L, et al. Acute biomarkers of traumatic brain injury: relationship between plasma levels of ubiquitin c-terminal hydrolase-L1 and glial fibrillary acidic protein. J Neurotrauma 2014;31:19–25.
25. Papa L, Robertson CS, Wang KKW, et al. Biomarkers improve clinical outcome predictors of mortality following non-penetrating severe traumatic brain injury. Neurocrit Care 2014;22:52–64.
26. Espiga R, Vicente J, Poncela M, et al. Usefulness of determining serum S-100b protein expression in screening patients with minor head injury in a hospital emergency department. Emergencias 2011;23:15–21.
27. Ramezani F, Bahrami-Amiri A, Babahajian A, et al. Ubiquitin C-terminal hydrolase-L1 (UCHL1) in prediction of computed tomography findings in traumatic brain injury; a meta-analysis. Emergency 2018;6:e62.
28. Papa L, Silvestri S, Brophy GM, et al. GFAP Out-Performs S100b in detecting traumatic intracranial lesions on computed tomography in trauma patientswith mild traumatic brain injury and those with extracranial lesions. J Neurotrauma 2014;31:1815–1822.
29. Business Wire a Berkshire Hathaway CompanyFDA grants marketing authorization to banyan biomarkers for the first diagnostic blood test for traumatic brain injury [Internet]. San Diego: Businesswire.com. 2018;[Cited 2020 Feb 19]. Available at: https://www.businesswire.com/news/home/20180214006251/en/FDA-Grants-Marketing-Authorization-Banyan-Biomarkers-Diagnostic.
30. Banyan BTI. Brain Trauma Indicator for in vitro diagnostic use only. Banyan Biomarkers Inc., 2018; 1–39.
31. Mondello S, Muller U, Jeromin A, et al. Blood-based diagnosis of traumatic brain injury. Expert Rev Mol Diagn 2011;11:65–78.
32. Rodríguez Sanjuán A, Cervera E, Valencia Villa G, et al. Topic review: Neural and glial biomarkers as a quantitative classification strategy for traumatic brain severity. Salud Uninorte 2016;32:302–318.
33. Sedaghat F, Notopoulos A. S100 protein family and its application in clinical practice. Hippokratia 2008;12:198–204.
34. Lewis LM, Schloemann DT, Papa L, et al. Utility of serum biomarkers in the diagnosis and stratification of mild traumatic brain injury. Acad Emerg Med 2017;24:710–720.
35. Welch REM, Lewis L, Ayaz S, et al. Modeling the kinetics of serum glial fibrillary acidic protein, ubiquitin carboxyl-terminal hydrolase-L1, and S100B concentrations in patients with traumatic brain injury. J Neurotrauma 2017;34:1957–1971.
36. Hill-Pryor CWK, Papa L, Lopez M, et al. Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury. Am Med Assoc 2016;73:551–560.
How to Cite
1.
Mendoza DA, López KD, Echeverri RA, Pastor L, Rueda S, Fernández LL, et al. Utility of biomarkers in traumatic brain injury: a narrative review. Colomb. J. Anesthesiol. [Internet]. 2020 Jul. 1 [cited 2024 Apr. 19];48(3):155-61. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/912
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Published
2020-07-01
How to Cite
1.
Mendoza DA, López KD, Echeverri RA, Pastor L, Rueda S, Fernández LL, et al. Utility of biomarkers in traumatic brain injury: a narrative review. Colomb. J. Anesthesiol. [Internet]. 2020 Jul. 1 [cited 2024 Apr. 19];48(3):155-61. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/912
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Narrative review
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