Evaluation of serum ubiquitin C-terminal hydrolase L1 as a predictor of severe traumatic brain injury outcomes

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

Abstract


The purpose of the study was to investigate the potential of determining the serum concentration of neuronal damage biomarker ubiquitin C-terminal hydrolase L1 (UCH-L1) for predicting the outcomes of traumatic brain injury (TBI).

Methods. We analyzed the results of diagnostic tests and therapeutic interventions in 72 patients aged 16 to 76 years with severe traumatic brain injury of different origin with the assessment of its outcomes. The results of the molecular biological study (determining the UCH-L1 serum concentration by solid phase enzyme immunoassay — ELISA using sets of reagents Sigma-Aldrich, USA, on the 1st day after severe TBI) were compared with the analyzes of 10 healthy donors. The TBI outcomes were assessed by Glasgow Outcome Scale (GOS) in 6 months after injury. A correlation of severe TBI outcomes with UCH-L1 serum levels obtained on the 1st day after injury was evaluated.

Results. In patients with isolated severe TBI, after exclusion of concomitant extracranial injuries, intoxication and other causes for unconsciousness, serum levels of UCH-L1 exceeding the cut-off value of 29.5 ng/ml indicated a high probability of patient’s death (sensitivity of the model was 91.2 %, specificity — 94.7 %). The levels of serum UCH-L1 exceeding the cut-off value of 15.2 ng/ml on the 1st day after severe TBI was a marker of a high probability of unfavorable outcomes in 6 months after the trauma, which include death and severe disability (sensitivity of the model was 100 %, specificity — 86.7 %).

Conclusion. The estimation of serum concentration of neuronal damage biomarker UCH-L1 in patients with severe TBI on the 1st day after injury demonstrated a high effectiveness for predicting the TBI outcomes in 6 months after injury.


Keywords


traumatic brain injury; prognosis; biomarkers; UCH-L1

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DOI: https://doi.org/10.25305/unj.96099

Copyright (c) 2017 Oleg Y. Kobyletsky, Lyudmyla M. Bielska, Volodymyr M. Shevaha, Vadym V. Biloshytsky

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