Possibilities of biochemical biomarkers in prognosis of traumatic brain injury course
Keywords:traumatic brain injury, biomarkers
AbstractLimitations of available diagnostic and prognostic tools caused evaluation of potential biochemical biomarkers of traumatic brain injury (TBI). The “ideal” TBI biomarker should: 1) have highly sensitive and specific in TBI; 2) stratify the injured persons depending on TBI severity; 3) easily detected by a minimally invasive and inexpensive methods; 4) provide information about extent and mechanisms of brain damage; 5) reflect disease progression and treatment efficacy; 6) provide the ability to predict injury’s functional consequences. The main compounds that can be used as TBI biomarkers are calcium-binding protein S100B, ubiquitin carboxy hydrolase L1 (ubiquitin carboxy-terminal hydrolase-L1 — UCH-L1), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), αII-spectrin decomposition products (SBDP). Today there are no ideal biomarkers that meet most of these requirements. Some of them are lowly sensitive and low specific (NSE), or highly sensitive and lowly specific (S100B); GFAP is a highly specific marker of TBI with potential to predict consequences of severe injury, although it’s capabilities at mild or moderate TBI are not clear. Further more, GFAP level reflects mainly the presence and amount of focal lesions, where as other molecules better reflect the severity of diffuse brain injury (UCH-L1, SBDP). Combined use of biomarkers may have diagnostic and prognostic value at TBI in clinic. Properties of certain biomarkers can complement limitations or shortcomings of other biomarkers. Such combinations of biomarkers may include S100B, UCH-L1, GFAP, NSE, and SBDP.
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