The game changer: UCH-L1 and GFAP-based blood test as the first marketed in vitro diagnostic test for mild traumatic brain injury

Expert Rev Mol Diagn. 2024 Jan-Feb;24(1-2):67-77. doi: 10.1080/14737159.2024.2306876. Epub 2024 Jan 31.

Abstract

Introduction: Major organ-based in vitro diagnostic (IVD) tests like ALT/AST for the liver and cardiac troponins for the heart are established, but an approved IVD blood test for the brain has been missing, highlighting a gap in medical diagnostics.

Areas covered: In response to this need, Abbott Diagnostics secured FDA clearance in 2021 for the i-STAT Alinity™, a point-of-care plasma blood test for mild traumatic brain injury (TBI). BioMerieux VIDAS, also approved in Europe, utilizes two brain-derived protein biomarkers: neuronal ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP). These biomarkers, which are typically present in minimal amounts in healthy individuals, are instrumental in diagnosing mild TBI with potential brain lesions. The study explores how UCH-L1 and GFAP levels increase significantly in the bloodstream following traumatic brain injury, aiding in early and accurate diagnosis.

Expert opinion: The introduction of the i-STAT Alinity™ and the Biomerieux VIDAS TBI blood tests mark a groundbreaking development in TBI diagnosis. It paves the way for the integration of TBI biomarker tools into clinical practice and therapeutic trials, enhancing the precision medicine approach by generating valuable data. This advancement is a critical step in addressing the long-standing gap in brain-related diagnostics and promises to revolutionize the management and treatment of mild TBI.

Keywords: GFAP; TBI; Traumatic brain injury; UCH-L1; biomarkers; mild TBI.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Brain Concussion*
  • Brain Injuries, Traumatic* / diagnosis
  • Diagnostic Tests, Routine
  • Glial Fibrillary Acidic Protein
  • Hematologic Tests
  • Humans
  • Ubiquitin Thiolesterase

Substances

  • Glial Fibrillary Acidic Protein
  • Ubiquitin Thiolesterase
  • Biomarkers