Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Drs Chandran, Kane, Hackney, and Mihalik, Messrs Powell and Boltz, and Ms DeCicco); Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana (Dr Chandran); Defense Medical Strategies LLC, Fayetteville, North Carolina (Mr DeLellis); and United States Army Special Operations Command, Fort Bragg, North Carolina (COL Lynch, COL Means, and MAJ Healy).
J Head Trauma Rehabil. 2020 Sep/Oct;35(5):300-307. doi: 10.1097/HTR.0000000000000598.
Special Operations Forces (SOF) combat soldiers are frequently exposed to blast and blunt neurotrauma, most often classified as mild traumatic brain injury (mTBI). Repetitive mTBI may increase the risk of developing long-term neurological sequelae. Identifying changes in neuroinflammatory biomarkers before chronic conditions emerge could serve as preliminary evidence of developing neuropathology.
To determine the effects of mTBI history, lifetime mTBI incidence, and recency on blood biomarker concentrations of axonal protein neurofilament light (NfL), glycolytic enzyme neuron-specific enolase (NSE), astrocyte-expressed S100 calcium-binding protein B (S100B), and neurotrophic cytokine interleukin-6 (IL-6) in healthy, active duty SOF combat soldiers.
Self-reported mTBI history/recency and fasted blood samples were collected in this cross-sectional study of 104 asymptomatic SOF combat soldiers. Biomarker concentrations were quantified using commercial enzyme-linked immunosorbent assays. Mann-Whitney U and Kruskal-Wallis tests were used to compare groups. Post hoc tests with appropriate corrections were conducted as warranted.
Soldiers with mTBI history had higher NSE concentrations than those without (z = -2.60, P = .01). We also observed significant main effects of lifetime mTBI incidence on NSE (χ(3) = 9.52, P = .02) and S100B (χ(3) = 8.21, P = .04) concentrations and a significant main effect of mTBI recency on NfL concentration (χ(2) = 6.02, P = .049).
The SOF combat soldiers with mTBI history had increased NSE. Longitudinal studies in this population are needed due to between-subject heterogeneity in biomarker concentrations. The NfL concentrations in our SOF combat soldiers-regardless of mTBI history or recency-were similar to values previously reported in civilian acute TBI patients.
特种作战部队（SOF）战斗人员经常暴露于爆炸和钝性神经创伤中，最常见的是轻度创伤性脑损伤（mTBI）。重复 mTBI 可能会增加发展为长期神经后遗症的风险。在出现慢性疾病之前，识别神经炎症生物标志物的变化可能是神经病理学发展的初步证据。
确定 mTBI 病史、终生 mTBI 发生率和近期发生对健康、现役 SOF 战斗士兵血液生物标志物轴突蛋白神经丝轻链（NfL）、糖酵解酶神经元特异性烯醇化酶（NSE）、星形胶质细胞表达的 S100 钙结合蛋白 B（S100B）和神经营养细胞因子白细胞介素-6（IL-6）浓度的影响。
在这项对 104 名无症状 SOF 战斗士兵的横断面研究中，自我报告 mTBI 病史/近期发生情况并采集空腹血液样本。使用商业酶联免疫吸附试验定量生物标志物浓度。使用 Mann-Whitney U 和 Kruskal-Wallis 检验比较组。如有需要，进行适当校正的事后检验。
有 mTBI 病史的士兵的 NSE 浓度高于无 mTBI 病史的士兵（z = -2.60，P =.01）。我们还观察到终生 mTBI 发生率对 NSE（χ(3) = 9.52，P =.02）和 S100B（χ(3) = 8.21，P =.04）浓度的显著主效应，以及 mTBI 近期发生对 NfL 浓度的显著主效应（χ(2) = 6.02，P =.049）。
有 mTBI 病史的 SOF 战斗士兵的 NSE 增加。由于生物标志物浓度的个体间异质性，需要在该人群中进行纵向研究。我们的 SOF 战斗士兵的 NfL 浓度——无论是否有 mTBI 病史或近期发生——都与以前在平民急性 TBI 患者中报告的值相似。
