1 Institute of Legal Medicine, Medical Faculty, University of Leipzig , Leipzig, Germany .
2 Institute for Medical Informatics, Statistics, and Epidemiology, Medical Faculty, University of Leipzig , Leipzig, Germany .
J Neurotrauma. 2018 Sep 1;35(17):2044-2055. doi: 10.1089/neu.2017.5441. Epub 2018 Jul 6.
Until now, it is impossible to identify a fatal traumatic brain injury (TBI) before post-mortem radiological investigations or an autopsy take place. It would be preferable to have an additional diagnostic tool such as post-mortem biochemistry to get greater insight into the pathological pathways and survival times after sustaining TBI. Cerebrospinal fluid (CSF) and serum samples of 84 autopsy cases were collected from forensic autopsies with post-mortem intervals (PMI) of up to 148 h. The cases were categorized into a fatal TBI case group (n = 42) and non-TBI controls (n = 42). The values of glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), and neutrophil gelatinase-associated lipocalin (NGAL) were analyzed by means of quantitative chemiluminescent multiplex immunoassays. The main results indicate that the usage of liquid samples with good macroscopic quality is more relevant for meaningful biomarker analyses than the length of the PMI. All three proteins were shown to differentiate TBI fatalities from the controls in CSF. In serum, only GFAP could be shown to be able to identify TBI cases. This study is the first approach to measure the three proteins together in CSF and serum in autopsy cases. Determined threshold values may differentiate between fatal TBI and control cases. The presented results emphasize the possible use of post-mortem biochemistry as a supplemental tool in everyday forensic routine.
到目前为止，在进行死后放射学调查或尸检之前，不可能确定致命性创伤性脑损伤 (TBI)。最好有一个额外的诊断工具，如死后生物化学，以更深入地了解 TBI 后的病理途径和存活时间。从尸检中收集了 84 例死后间隔（PMI）长达 148 小时的法医尸检的脑脊液 (CSF) 和血清样本。这些病例分为致命性 TBI 病例组（n=42）和非 TBI 对照组（n=42）。通过定量化学发光多重免疫分析来分析神经胶质纤维酸性蛋白 (GFAP)、脑源性神经营养因子 (BDNF) 和中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 的值。主要结果表明，与 PMI 的长度相比，使用具有良好宏观质量的液体样本对于有意义的生物标志物分析更为重要。所有三种蛋白质都能区分 CSF 中的 TBI 死亡和对照。在血清中，只有 GFAP 能够识别 TBI 病例。这项研究是首次在尸检病例中同时测量 CSF 和血清中的三种蛋白质。确定的阈值值可能区分致命性 TBI 和对照病例。所呈现的结果强调了死后生物化学作为日常法医常规辅助工具的可能用途。
