Serum Concentrations of Ubiquitin C-Terminal Hydrolase-L1 and Glial Fibrillary Acidic Protein after Pediatric Traumatic Brain Injury

Sci Rep. 2016 Jun 20:6:28203. doi: 10.1038/srep28203.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Biomarkers / blood
  • Brain Injuries, Traumatic / blood*
  • Brain Injuries, Traumatic / diagnosis*
  • Brain Injuries, Traumatic / pathology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Glial Fibrillary Acidic Protein / blood*
  • Humans
  • Male
  • Myelin Basic Protein / blood
  • Prospective Studies
  • S100 Calcium Binding Protein beta Subunit / blood
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ubiquitin Thiolesterase / blood*

Substances

  • Biomarkers
  • Glial Fibrillary Acidic Protein
  • MBP protein, human
  • Myelin Basic Protein
  • S100 Calcium Binding Protein beta Subunit
  • S100B protein, human
  • UCHL1 protein, human
  • Ubiquitin Thiolesterase