Wong Ker Rui, O'Brien William T, Sun Mujun, Yamakawa Glenn, O'Brien Terence J, Mychasiuk Richelle, Shultz Sandy R, McDonald Stuart J, Brady Rhys D
Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.
Biomark Insights. 2021 Oct 26;16:11772719211053449. doi: 10.1177/11772719211053449. eCollection 2021.
Serum neurofilament light (NfL) is an emerging biomarker of traumatic brain injury (TBI). However, the effect of peripheral injuries such as long bone fracture and skeletal muscle injury on serum NfL levels is unknown. Therefore, the aim of this study was to determine whether serum NfL levels can be used as a biomarker of TBI in the presence of concomitant peripheral injuries.
Rats were randomly assigned to one of four injury groups: polytrauma (muscle crush + fracture + TBI; n = 11); peripheral injuries (muscle crush + fracture + sham-TBI; n = 12); TBI-only (sham-muscle crush + sham-fracture + TBI; n = 13); and triple-sham (n = 7). At 2-days post-injury, serum levels of NfL were quantified using a Simoa HD-X Analyzer.
Compared to triple-sham rats, serum NfL concentrations were higher in rats with peripheral injuries-only, TBI-only, and polytrauma. When compared to peripheral injury-only rats, serum NfL levels were higher in TBI-only and polytrauma rats. No differences were found between TBI-only and polytrauma rats.
Serum NfL levels did not differ between TBI-only and polytrauma rats, indicating that significant peripheral injuries did not affect the sensitivity and specificity of serum NfL as a biomarker of moderate TBI. However, the finding of elevated serum NfL levels in rats with peripheral injuries in the absence of a TBI suggests that the presence of such injuries may limit the utility of NfL as a biomarker of less severe TBI (eg, concussion).
血清神经丝轻链（NfL）是创伤性脑损伤（TBI）一种新出现的生物标志物。然而，长骨骨折和骨骼肌损伤等外周损伤对血清NfL水平的影响尚不清楚。因此，本研究的目的是确定在存在合并外周损伤的情况下，血清NfL水平是否可作为TBI的生物标志物。
将大鼠随机分为四个损伤组之一：多发伤组（肌肉挤压伤+骨折+TBI；n = 11）；外周损伤组（肌肉挤压伤+骨折+假TBI；n = 12）；单纯TBI组（假肌肉挤压伤+假骨折+TBI；n = 13）；以及三联假手术组（n = 7）。在损伤后2天，使用Simoa HD-X分析仪定量测定血清NfL水平。
与三联假手术组大鼠相比，仅外周损伤组、仅TBI组和多发伤组大鼠的血清NfL浓度更高。与仅外周损伤组大鼠相比，仅TBI组和多发伤组大鼠的血清NfL水平更高。仅TBI组和多发伤组大鼠之间未发现差异。
仅TBI组和多发伤组大鼠的血清NfL水平无差异，表明严重外周损伤不影响血清NfL作为中度TBI生物标志物的敏感性和特异性。然而，在没有TBI的情况下，外周损伤大鼠血清NfL水平升高的发现表明，此类损伤的存在可能会限制NfL作为较轻TBI（如脑震荡）生物标志物的效用。
