title: Significance of ubiquitin carboxy-terminal hydrolase L1 elevations in athletes after sub-concussive head hits.
abstract: The impact of sub-concussive head hits (sub-CHIs) has been recently investigated in American football players, a population at risk for varying degrees of post-traumatic sequelae. Results show how sub-CHIs in athletes translate in serum as the appearance of reporters of blood-brain barrier disruption (BBBD), how the number and severity of sub-CHIs correlate with elevations of putative markers of brain injury is unknown. Serum brain injury markers such as UCH-L1 depend on BBBD. We investigated the effects of sub-CHIs in collegiate football players on markers of BBBD, markers of cerebrospinal fluid leakage (serum beta 2-transferrin) and markers of brain damage. Emergency room patients admitted for a clinically-diagnosed mild traumatic brain injury (mTBI) were used as positive controls. Healthy volunteers were used as negative controls. Specifically this study was designed to determine the use of UCH-L1 as an aid in the diagnosis of sub-concussive head injury in athletes. The extent and intensity of head impacts and serum values of S100B, UCH-L1, and beta-2 transferrin were measured pre- and post-game from 15 college football players who did not experience a concussion after a game. S100B was elevated in players experiencing the most sub-CHIs; UCH-L1 levels were also elevated but did not correlate with S100B or sub-CHIs. Beta-2 transferrin levels remained unchanged. No correlation between UCH-L1 levels and mTBI were measured in patients. Low levels of S100B were able to rule out mTBI and high S100B levels correlated with TBI severity. UCH-L1 did not display any interpretable change in football players or in individuals with mild TBI. The significance of UCH-L1 changes in sub-concussions or mTBI needs to be further elucidated.
authors.affiliation: Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America.
authors.forename: Vikram
authors.initials: V
authors.lastname: Puvenna
authors.affiliation: Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Clinical-Bioanalytical Chemistry, Cleveland State University, Cleveland, Ohio, United States of America.
authors.forename: Chanda
authors.initials: C
authors.lastname: Brennan
authors.affiliation: Department of Neuroscience, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Gerald
authors.initials: G
authors.lastname: Shaw
authors.affiliation: Department of Neuroscience, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Cui
authors.initials: C
authors.lastname: Yang
authors.affiliation: Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America.
authors.forename: Nicola
authors.initials: N
authors.lastname: Marchi
authors.affiliation: Departments of Emergency Medicine and Neurosurgery, University of Rochester Medical Center, Rochester, New York, United States of America.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Bazarian
authors.affiliation: Departments of Emergency Medicine and Neurosurgery, University of Rochester Medical Center, Rochester, New York, United States of America.
authors.forename: Kian
authors.initials: K
authors.lastname: Merchant-Borna
authors.affiliation: Cerebrovascular Research, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, United States of America; Department of Clinical-Bioanalytical Chemistry, Cleveland State University, Cleveland, Ohio, United States of America.
authors.forename: Damir
authors.initials: D
authors.lastname: Janigro
mesh_terms: D056352:Athletes / Q000706:statistics & numerical data; D001812:Blood-Brain Barrier / Q000378:metabolism / Q000473:pathology; D001924:Brain Concussion / Q000097:blood* / Q000201:enzymology* / Q000378:metabolism; D001930:Brain Injuries / Q000097:blood / Q000201:enzymology / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D014168:Transferrin / Q000378:metabolism; D043222:Ubiquitin Thiolesterase / Q000097:blood* / Q000378:metabolism*
chemical_list: D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; D014168:Transferrin; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase