Evaluation of serum ubiquitin C-terminal hydrolase L1 as a predictor of severe traumatic brain injury outcomes
DOI:
https://doi.org/10.25305/unj.96099Keywords:
traumatic brain injury, prognosis, biomarkers, UCH-L1Abstract
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.
References
1. Lekhan VМ, Huk AР. Osoblyvosti epidemiolohiyi cherepno-mozkovoyi travmy v Ukrayini [Specifics of traumatic brain injury epidemiology in Ukraine]. Ukrayina. Zdorov’ya natsiyi. 2010;2:7-14. Ukrainian.
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; 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 at: https://www.cdc.gov/traumaticbraininjury/pdf/future_of_registries-a.pdf
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; 29(9):1770-8. [CrossRef] [PubMed] [PMC free article]
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. [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. 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. [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. Zoltewicz JS, Mondello S, Yang B, Newsom KJ, Kobeissy F, Yao C, Lu XC, Dave JR, Shear DA, Schmid K, Rivera V, Cram T, Seaney J, Zhang Z, Wang KK, Hayes RL, Tortella FC. Biomarkers track damage after graded injury severity in a rat model of penetrating brain injury. J Neurotrauma. 2013;30(13):1161-9. [CrossRef] [PubMed]
14. Biloshytsky V, Kobyletsky O. [Possibilities of biochemical biomarkers in prognosis of traumatic brain injury course]. Ukrainian Neurosurgical Journal. 2015;1:4-15. [Abstract/Full Text]
15. Berger RP, Pierce MC, Wisniewski SR, Adelson PD, Clark RS, Ruppel RA, Kochanek PM. Neuron-specific enolase and S100B in cerebrospinal fluid after severe traumatic brain injury in infants and children. Pediatrics. 2002;109(2):E31. [PubMed]
16. Bramlett HM, Dietrich WD. Pathophysiology of cerebral ischemia and brain trauma: similarities and differences. J Cereb Blood Flow Metab. 2004;24(2):133-50. [PubMed]
17. 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] [PMC free article]
18. Sidyakina IV, Tsarenko SV, Dobrushina OR, Kaledina IV, Manevskiy AP, Shapovalenko TV, Lyadov KV. Prognosticheskaya model otsenki letalnosti i funktsionalnogo vosstanovleniya posle tyazhelogo i krayne tyazhelogo insulta. [The predictive model for estimating mortality and functional recovery after a severe stroke]. Nevrologicheskiy zhurnal. 2016; 17(2):10-4. Russian. [CrossRef]
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] [PMC free article]
20. Papa L, Robertson CS, Wang KK, Brophy GM, Hannay HJ, Heaton S, Schmalfuss I, Gabrielli A, Hayes RL, Robicsek SA. Biomarkers improve clinical outcome predictors of mortality following non-penetrating severe traumatic brain injury. Neurocrit Care. 2015;22(1):52-64. [CrossRef] [PubMed]
21. Li J, Yu C, Sun Y, Li Y. Serum ubiquitin C-terminal hydrolase L1 as a biomarker for traumatic brain injury: a systematic review and meta-analysis. Am J Emerg Med. 2015;33(9):1191-6. [CrossRef] [PubMed]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Oleg Y. Kobyletsky, Lyudmyla M. Bielska, Volodymyr M. Shevaha, Vadym V. Biloshytsky
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.