The study of UCH-L1 and S100B serum concentration in the diagnosis of diffuse and focal severe traumatic brain injury

Oleg Y. Kobyletsky, Lyudmyla M. Bielska, Volodymyr M. Shevaha, Vadym V. Biloshytsky


Purpose: To evaluate the feasibility of determining serum concentration of biomarker of neuronal protein damage UCH-L1 and biomarker of astroglia damage S100 on the 1st day after injury, particularly for the diagnosis of focal and diffuse brain impairments based on clinical and biochemical and computer tomographic study in patients with acute severe brain injury.

Methods. We used the results of diagnostic tests and therapeutic manipulations in 72 patients aged 16 to 76 years with severe traumatic brain injury. Correlation of the molecular biological study results (determining the UCH-L1 and S100B serum concentration by solid phase enzyme immunoassay — ELISA using sets of reagents Sigma-Aldrich, USA, on the 1st day after severe TBI) with the injury type (diffuse or focal according to L. F. Marshall classification) was evaluated.

Results. In patients with isolated severe TBI, after exclusion of concomitant extracranial injuries, intoxication and other causes for unconsciousness, UCH-L1 / S100B concentration ratio exceeding the cut-off value of 15.8 indicated a high probability of diffuse injury, ratio less than 15.8 was a marker of focal injury. The sensitivity of the model was 77.8%, specificity — 79.6%.

Conclusion. It has been shown that the estimation of serum concentration of neuronal damage biomarker UCH-L1 and astroglial damage biomarker S100B in patients with severe TBI on the 1st day after injury allows diagnose diffuse and focal brain damage with high efficiency.


traumatic brain injury; diffuse injury; focal injury; biomarkers; UCH-L1; S100B


1. Lekhan VМ, Huk AР. [Specifics of traumatic brain injury epidemiology in Ukraine]. Ukrayina. Zdorov’ya natsiyi. 2010;(2):7-14. Ukrainian. [VernadskyNLU]

2. Chen X, Zhang KL, Yang SY, Dong JF, Zhang JN. Glucocorticoids aggravate retrograde memory deficiency associated with traumatic brain injury in rats. J Neurotrauma. 2009 Feb 11;26(2):253-60. [CrossRef] [PubMed]

3. Langlois JA, Rutland-Brown W. Traumatic Brain Injury in the United States: The Future of Registries and Data Systems. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2005. Available from:

4. Fujimoto ST, Longhi L, Saatman KE, Conte V, Stocchetti N, McIntosh TK. Motor and cognitive function evaluation following experimental traumatic brain injury. Neurosci Biobehav Rev. 2004;28(4):365-78. [CrossRef] [PubMed]

5. Czeiter E, Mondello S, Kovacs N, Sandor J, Gabrielli A, Schmid K, Tortella F, Wang KK, Hayes RL, Barzo P, Ezer E, Doczi T, Buki A. Brain injury biomarkers may improve the predictive power of the IMPACT outcome calculator. J Neurotrauma. 2012 Jun 10;29(9):1770-8. [CrossRef] [PubMed] [PubMed Central]

6. Nelson DW, Rudehill A, MacCallum RM, Holst A, Wanecek M, Weitzberg E, Bellander BM. Multivariate outcome prediction in traumatic brain injury with focus on laboratory values. J Neurotrauma. 2012;29(17):2613-24. [CrossRef] [PubMed]

7. Lo TY, Jones PA, Minns RA. Combining coma score and serum biomarker levels to predict unfavorable outcome following childhood brain trauma. J Neurotrauma. 2010;27(12):2139-45. [CrossRef] [PubMed]

8. Perel P, Arango M, Clayton T, Edwards P, Komolafe E, Poccock S, Roberts I, Shakur H, Steyerberg E, Yutthakasemsunt S. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ. 2008;336(7641):425-29. [CrossRef] [PubMed]

9. Steyerberg E, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, Murray GD, Marmarou A, Roberts I, Habbema JD, Maas AI. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. Plos Med. 2008;5(8):e165. [CrossRef] [PubMed]

10. Rowley G, Fielding K. Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Lancet. 1991;337(8740):535-8. [PubMed]

11. Davis DP, Serrano JA, Vilke GM, Sise MJ, Kennedy F, Eastman AB, Velky T, Hoyt DB. The predictive value of field versus arrival Glasgow Coma Scale score and TRISS calculations in moderate-to-severe traumatic brain injury. J Trauma. 2006;60(5):985-90. [CrossRef] [PubMed]

12. Saatman K, Duhaime A, Bullock R, Maas A, Valadka A, Manley G. Classification of traumatic brain injury for targeted therapies. Journal of Neurotrauma. 2008;25(7):719-38. [CrossRef] [PubMed]

13. Marshall LF, Marshall SB, Klauber MR, Clark MVB, Eisenberg HM, Jane JA, Luerssen TG, Marmarou A, Foulkes MA. A new classification of head injury based on computerized tomography. Journal of Neurotrauma. Special Supplements. 1991;75(1S), S14–S20. [CrossRef]

14. Pedachenko E, Dzyak L, Sirko A. Severe diffuse brain injury. Justifiability of decompressive craniectomy. Ukrainian Neurosurgical Journal. 2015;(4):22-32. [CrossRef]

15. Dzyak L, Zorin N, Sirko A, Suk V, Grishin V. Intracranial pressure monitoring in patients with severe traumatic brain injury. Ukrainian Neurosurgical Journal. 2008;(1):17-22. [Abstract/Full Text]

16. Kobyletsky O, Bielska L, Shevaha V, Biloshytsky V. Evaluation of serum ubiquitin C-terminal hydrolase L1 as a predictor of severe traumatic brain injury outcomes. Ukrainian Neurosurgical Journal. 2017;(1):24-32. [CrossRef]

17. Kobyletsky O, Bielska L, Shevaha V, Biloshytsky V. Potentialities of evaluation of serum level of S100B for predicting the consequences of severe traumatic brain injury. Ukrainian Neurosurgical Journal. 2017;(2):50-6. [CrossRef]

18. Mondello S, Jeromin A, Buki A, Bullock R, Czeiter E, Kovacs N, Barzo P, Schmid K, Tortella F, Wang KK, Hayes RL. Glial neuronal ratio: a novel index for differentiating injury type in patients with severe traumatic brain injury. J Neurotrauma. 2012;29(6):1096-104. [CrossRef] [PubMed] [PubMed Central]

19. Lee JY, Lee CY, Kim HR, Lee CH, Kim HW, Kim JH. A role of serum-based neuronal and glial markers as potential predictors for distinguishing severity and related outcomes in traumatic brain injury. J Korean Neurosurg Soc. 2015;58(2):93-100. [CrossRef] [PubMed] [PubMed Central]

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