Glushakova Olena Y, Glushakov Alexander V, Hayes Ronald L
Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.
Single Breath, Inc., Gainesville, FL, USA.
Brain Circ. 2016 Jul-Sep;2(3):129-132. doi: 10.4103/2394-8108.192518. Epub 2016 Oct 18.
As traumatic brain injury (TBI) continues to affect children and young adults worldwide, research on reliable biomarkers grows as a possible aid in determining the severity of injury. However, many studies have revealed that diverse biomarkers such as S100B and myelin basic protein (MBP) have many limitations, such as their elevated normative concentrations in young children. Therefore, the results of these studies have yet to be translated to clinical applications. However, despite the setbacks of research into S100B and MBP, investigators continue to research viable biomarkers, notably glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1), as possible aids in medical decision making. Studies have revealed that GFAP and UCH-L1 actually are better predictors of injury progression than the before-mentioned biomarkers S100B and MBP. In addition, UCH-L1 has demonstrated an ability to detect injury while CT is negative, suggesting an ability to detect acute intracranial lesions. Here, we evaluate research testing levels of GFAP and UCH-L1 on children diagnosed with TBI and compare our results to those of other tested biomarkers. In a recent study done by Hayes ., GFAP and UCH-L1 demonstrated the potential to recognize children with the possibility of poor outcome, allowing for more specialized treatments with clinical and laboratory applications. Although studies on GFAP and UCH-L1 have for the most part warranted positive results, further studies will be needed to confirm their role as reliable markers for pediatric TBI.
由于创伤性脑损伤(TBI)持续影响着全球的儿童和年轻人,对可靠生物标志物的研究不断增加,有望辅助确定损伤的严重程度。然而,许多研究表明,诸如S100B和髓鞘碱性蛋白(MBP)等多种生物标志物存在诸多局限性,比如在幼儿中的正常浓度会升高。因此,这些研究结果尚未转化为临床应用。然而,尽管对S100B和MBP的研究遭遇挫折,研究人员仍在继续探索可行的生物标志物,特别是胶质纤维酸性蛋白(GFAP)和泛素C末端水解酶L1(UCH-L1),以期辅助医疗决策。研究表明,GFAP和UCH-L1实际上比上述生物标志物S100B和MBP更能预测损伤进展。此外,UCH-L1已显示出在CT检查呈阴性时检测损伤的能力,表明其能够检测急性颅内病变。在此,我们评估了针对诊断为TBI的儿童进行的GFAP和UCH-L1检测水平研究,并将我们的结果与其他检测的生物标志物的结果进行比较。在海斯等人最近进行的一项研究中,GFAP和UCH-L1显示出识别预后可能不佳儿童的潜力,从而能够在临床和实验室应用中进行更具针对性的治疗。尽管对GFAP和UCH-L1的研究大多取得了积极结果,但仍需要进一步研究来证实它们作为小儿TBI可靠标志物的作用。