IRCCS Centro Neurolesi Bonino-Pulejo, SS 113, Via Palermo, C da Casazza, 98124 Messina, Italy.
Neurocrit Care. 2012 Jun;16(3):470-7. doi: 10.1007/s12028-012-9707-z.
Recent advances in medicine, intensive care and diagnostic imaging modalities have led to a pronounced reduction in deaths and disability resulting from traumatic brain injury. However, there are not sufficient findings to evaluate and quantify the severity of the initial and secondary processes destructive and therefore there are not effective therapeutic measures to effectively predict the outcome. For this reason, in recent decades, researchers and clinicians have focused on specific markers of cellular brain injury to improve the diagnosis and the evaluation of outcome. Many proteins synthesized in the astroglia cells or in the neurons, such as neuron-specific enolase, S100 calcium binding protein B, myelin basic protein, creatine kinase brain isoenzyme, glial fibrillary acidic protein, plasma desoxyribonucleic acid, brain-derived neurotrophic factor, and ubiquitin carboxy-terminal hydrolase-L1, have been proposed as potential markers for cell damage in central nervous system. Usually, the levels of these proteins increase following brain injury and are found in increasing concentrations in the cerebrospinal fluid depending on the injury magnitude, and can also be found in blood stream because of a compromised blood-brain barrier. In this review, we examine the various factors that must be taken into account in the search for a reliable non-invasive biomarkers in traumatic brain injury and their role in the diagnosis and outcome evaluation.
近年来，医学、重症监护和诊断成像技术的进步显著降低了创伤性脑损伤导致的死亡率和残疾率。然而，目前还没有足够的研究结果来评估和量化初始和继发过程的严重程度，因此也没有有效的治疗措施来有效预测结果。出于这个原因，在最近几十年，研究人员和临床医生专注于细胞脑损伤的特定标志物，以改善诊断和预后评估。许多在星形胶质细胞或神经元中合成的蛋白质，如神经元特异性烯醇化酶、S100 钙结合蛋白 B、髓鞘碱性蛋白、肌酸激酶脑同工酶、胶质纤维酸性蛋白、血浆去氧核糖核酸、脑源性神经营养因子和泛素羧基末端水解酶-L1，已被提议作为中枢神经系统细胞损伤的潜在标志物。通常，这些蛋白质的水平在脑损伤后会增加，并根据损伤程度在脑脊液中以递增的浓度存在，并且由于血脑屏障受损，也可以在血流中发现。在这篇综述中，我们探讨了在创伤性脑损伤中寻找可靠的非侵入性生物标志物时必须考虑的各种因素，以及它们在诊断和预后评估中的作用。
