Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and Glial Fibrillary Acidic Protein after Pediatric Traumatic Brain Injury.
Objective reliable markers to assess traumatic brain injury (TBI) and predict outcome soon after injury are a highly needed tool for optimizing management of pediatric TBI. We assessed serum concentrations of Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-Terminal Hydrolase-L1 (UCH-L1) in a cohort of 45 children with clinical diagnosis of TBI (Glasgow Coma Scale [GCS] 3-15) and 40 healthy subjects, evaluated their associations with clinical characteristics and outcomes, and compared their performance to previously published data on two well-studied blood biomarkers, S100B and MBP. We observed higher serum levels of GFAP and UCH-L1 in brain-injured children compared with controls and also demonstrated a step-wise increase of biomarker concentrations over the continuum of severity from mild to severe TBI. Furthermore, while we found that only the neuronal biomarker UCH-L1 holds potential to detect acute intracranial lesions as assessed by computed tomography (CT), both markers were substantially increased in TBI patients even with a normal CT suggesting the presence of undetected microstructural injuries. Serum UCH-L1 and GFAP concentrations also strongly predicted poor outcome and performed better than S100B and MBP. Our results point to a role of GFAP and UCH-L1 as candidate biomarkers for pediatric TBI. Further studies are warranted.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
Stefania
S
Mondello
Department of Psychiatry, University of Florida, Gainesville, FL, USA.
Firas
F
Kobeissy
Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy.
Annarita
A
Vestri
Banyan Biomarkers, Inc. Alachua, FL, USA.
Ronald L
RL
Hayes
Department of Critical Care Medicine, Safar Center for Resuscitation Research, Pittsburgh, PA, USA.
Patrick M
PM
Kochanek
Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
Rachel P
RP
Berger
D015415:Biomarkers / Q000097:blood; D000070642:Brain Injuries, Traumatic / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood*; D006801:Humans; D008297:Male; D004676:Myelin Basic Protein / Q000097:blood; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D043222:Ubiquitin Thiolesterase / Q000097:blood*
D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; C499048:MBP protein, human; D004676:Myelin Basic Protein; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase