Neuroscience & Ophthalmology Research Group, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK.
National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, UK.
Sci Rep. 2017 Jul 10;7(1):5002. doi: 10.1038/s41598-017-04722-5.
Traumatic brain injury (TBI) is set to become the leading cause of neurological disability across all age groups. Currently, no reliable biomarkers exist to help diagnose the severity of TBI to identify patients who are at risk of developing secondary injuries. Thus, the discovery of reliable biomarkers for the management of TBI would improve clinical interventions. Inflammatory markers are particularly suited for biomarker discovery as TBI leads to very early alterations in inflammatory proteins. Using the Proseek Multiplex Inflammation assay, we measured in patients that had suffered mild TBI (n = 10) or severe TBI (n = 10) with extra-cranial injury or extracranial injury only (EC) (n = 10), 92 inflammation-associated proteins in serum obtained: <1 hr (within 1-hour), 4-12 hr and 48-72 hr post injury. Changes were compared to healthy volunteers (HV). Our results identified CST5, AXIN1 and TRAIL as novel early biomarkers of TBI. CST5 identified patients with severe TBI from all other cohorts and importantly was able to do so within the first hour of injury. AXIN1 and TRAIL were able to discriminate between TBI and HV at <1 hr. We conclude that CST5, AXIN1 and TRAIL are worthy of further study in the context of a pre-hospital or pitch-side test to detect brain injury.
创伤性脑损伤 (TBI) 将成为所有年龄段人群中导致神经残疾的主要原因。目前，尚无可靠的生物标志物可用于帮助诊断 TBI 的严重程度，以确定有发生继发性损伤风险的患者。因此，发现可靠的 TBI 管理生物标志物将改善临床干预措施。炎症标志物特别适合用于生物标志物的发现，因为 TBI 会导致炎症蛋白的早期改变。我们使用 Proseek 多重炎症分析试剂盒，在有颅脑外损伤或仅有颅脑外损伤的轻度 TBI 患者（n=10）或重度 TBI 患者（n=10）中测量了发病后 1 小时内（<1 小时）、4-12 小时和 48-72 小时获得的血清中 92 种与炎症相关的蛋白。将结果与健康志愿者 (HV) 进行比较。我们的结果确定 CST5、AXIN1 和 TRAIL 为 TBI 的新型早期生物标志物。CST5 能够将重度 TBI 患者与其他所有队列区分开来，而且重要的是，它能够在受伤后 1 小时内完成。AXIN1 和 TRAIL 能够在<1 小时内区分 TBI 和 HV。我们得出结论，CST5、AXIN1 和 TRAIL 值得进一步研究，以用于在院前或场边测试中检测脑损伤。
