title: Serum amyloid A is increased in children with abusive head trauma: a gel-based proteomic analysis.
abstract: BACKGROUND
  Abusive head trauma (AHT) is the leading cause of death from traumatic brain injury in infants and young children. Identification of mild AHT (Glasgow Coma Scale score: 13-15) is difficult because children can present with nonspecific symptoms and with no history of trauma.
  
  
  METHODS
  Two-dimensional difference gel electrophoresis combined with mass spectrometry was used to compare the serum protein profile of children with mild AHT and age-matched controls. Protein changes were confirmed by western blots. Western blots were performed using serum from children with mild, moderate, and severe AHT to assess the effect of injury severity on protein intensity. The protein identified--serum amyloid A (SAA)--was then measured by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Using serum from 18 mild AHT cases and 20 controls, there were ~1,000 protein spots; 2 were significantly different between groups. Both spots were identified as SAA. There was no relationship between protein levels and injury severity. SAA concentrations measured by enzyme-linked immunosorbent assay were increased in cases vs. controls.
  
  
  CONCLUSIONS
  SAA may be a potential biomarker to identify children with mild AHT who present for medical care without a history of trauma and who might otherwise not be recognized as needing a head computed tomography.
authors.affiliation: Department of Environmental Toxicology, The Institute of Environmental and Human Health, Texas Tech University, Lubbock, Texas.
authors.forename: Weimin
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Environmental Toxicology, The Institute of Environmental and Human Health, Texas Tech University, Lubbock, Texas.
authors.forename: Chuanwen
authors.initials: C
authors.lastname: Lu
authors.affiliation: 1] Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania [2] Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kochanek
authors.affiliation: 1] Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania [2] Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Berger
mesh_terms: D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000097:blood / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D040901:Proteomics / Q000379:methods*; D000685:Serum Amyloid A Protein / Q000032:analysis*; D053719:Tandem Mass Spectrometry; D057825:Two-Dimensional Difference Gel Electrophoresis
chemical_list: D015415:Biomarkers; D000685:Serum Amyloid A Protein