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Blood biomarkers for traumatic brain injury : A narrative review of current evidence

Hossain, Iftakher ; Marklund, Niklas LU orcid ; Czeiter, Endre ; Hutchinson, Peter and Buki, Andras (2024) In Brain and Spine 4.
Abstract

Introduction: A blood-based biomarker (BBBM) test could help to better stratify patients with traumatic brain injury (TBI), reduce unnecessary imaging, to detect and treat secondary insults, predict outcomes, and monitor treatment effects and quality of care. Research question: What evidence is available for clinical applications of BBBMs in TBI and how to advance this field? Material and methods: This narrative review discusses the potential clinical applications of core BBBMs in TBI. A literature search in PubMed, Scopus, and ISI Web of Knowledge focused on articles in English with the words “traumatic brain injury” together with the words “blood biomarkers”, “diagnostics”, “outcome prediction”, “extracranial injury” and “assay... (More)

Introduction: A blood-based biomarker (BBBM) test could help to better stratify patients with traumatic brain injury (TBI), reduce unnecessary imaging, to detect and treat secondary insults, predict outcomes, and monitor treatment effects and quality of care. Research question: What evidence is available for clinical applications of BBBMs in TBI and how to advance this field? Material and methods: This narrative review discusses the potential clinical applications of core BBBMs in TBI. A literature search in PubMed, Scopus, and ISI Web of Knowledge focused on articles in English with the words “traumatic brain injury” together with the words “blood biomarkers”, “diagnostics”, “outcome prediction”, “extracranial injury” and “assay method” alone-, or in combination. Results: Glial fibrillary acidic protein (GFAP) combined with Ubiquitin C-terminal hydrolase-L1(UCH-L1) has received FDA clearance to aid computed tomography (CT)-detection of brain lesions in mild (m) TBI. Application of S100B led to reduction of head CT scans. GFAP may also predict magnetic resonance imaging (MRI) abnormalities in CT-negative cases of TBI. Further, UCH-L1, S100B, Neurofilament light (NF-L), and total tau showed value for predicting mortality or unfavourable outcome. Nevertheless, biomarkers have less role in outcome prediction in mTBI. S100B could serve as a tool in the multimodality monitoring of patients in the neurointensive care unit. Discussion and conclusion: Largescale systematic studies are required to explore the kinetics of BBBMs and their use in multiple clinical groups. Assay development/cross validation should advance the generalizability of those results which implicated GFAP, S100B and NF-L as most promising biomarkers in the diagnostics of TBI.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood biomarkers, Diagnostics, Outcome prediction, Traumatic brain injury
in
Brain and Spine
volume
4
article number
102735
publisher
Elsevier
external identifiers
  • scopus:85180350517
ISSN
2772-5294
DOI
10.1016/j.bas.2023.102735
language
English
LU publication?
yes
id
82008929-2e17-471e-9216-df461a18faeb
date added to LUP
2024-01-31 14:02:16
date last changed
2024-01-31 14:04:10
@article{82008929-2e17-471e-9216-df461a18faeb,
  abstract     = {{<p>Introduction: A blood-based biomarker (BBBM) test could help to better stratify patients with traumatic brain injury (TBI), reduce unnecessary imaging, to detect and treat secondary insults, predict outcomes, and monitor treatment effects and quality of care. Research question: What evidence is available for clinical applications of BBBMs in TBI and how to advance this field? Material and methods: This narrative review discusses the potential clinical applications of core BBBMs in TBI. A literature search in PubMed, Scopus, and ISI Web of Knowledge focused on articles in English with the words “traumatic brain injury” together with the words “blood biomarkers”, “diagnostics”, “outcome prediction”, “extracranial injury” and “assay method” alone-, or in combination. Results: Glial fibrillary acidic protein (GFAP) combined with Ubiquitin C-terminal hydrolase-L1(UCH-L1) has received FDA clearance to aid computed tomography (CT)-detection of brain lesions in mild (m) TBI. Application of S100B led to reduction of head CT scans. GFAP may also predict magnetic resonance imaging (MRI) abnormalities in CT-negative cases of TBI. Further, UCH-L1, S100B, Neurofilament light (NF-L), and total tau showed value for predicting mortality or unfavourable outcome. Nevertheless, biomarkers have less role in outcome prediction in mTBI. S100B could serve as a tool in the multimodality monitoring of patients in the neurointensive care unit. Discussion and conclusion: Largescale systematic studies are required to explore the kinetics of BBBMs and their use in multiple clinical groups. Assay development/cross validation should advance the generalizability of those results which implicated GFAP, S100B and NF-L as most promising biomarkers in the diagnostics of TBI.</p>}},
  author       = {{Hossain, Iftakher and Marklund, Niklas and Czeiter, Endre and Hutchinson, Peter and Buki, Andras}},
  issn         = {{2772-5294}},
  keywords     = {{Blood biomarkers; Diagnostics; Outcome prediction; Traumatic brain injury}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Brain and Spine}},
  title        = {{Blood biomarkers for traumatic brain injury : A narrative review of current evidence}},
  url          = {{http://dx.doi.org/10.1016/j.bas.2023.102735}},
  doi          = {{10.1016/j.bas.2023.102735}},
  volume       = {{4}},
  year         = {{2024}},
}