Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.
Department of Anatomy, Physiology, and Genetics, Uniformed Services University, Bethesda, Maryland, USA.
J Neurotrauma. 2022 Jun;39(11-12):800-808. doi: 10.1089/neu.2021.0493.
Clinical decisions related to sports-related concussion (SRC) are challenging, because of the heterogenous nature of SRC symptoms coupled with the current reliance on subjective self-reported symptom measures. Sensitive and objective methods that can diagnose SRC and determine recovery would aid clinical management, and there is evidence that SRC induces changes in circulating protein biomarkers, indicative of neuroaxonal injury. However, potential blood biomarkers related to other pathobiological responses linked to SRC are still poorly understood. Therefore, here we analyzed blood samples from concussed (male = 30; female = 9) and non-concussed (male = 74; female = 27) amateur Australian rules football players collected during the pre-season (i.e., baseline), and at 2, 6, and 13 days post-SRC to determine time-dependent changes in serum levels of biomarkers related to glial (i.e., brain lipid-binding protein [BLBP]; phosphoprotein enriched in astrocytes 15) and cerebrovascular injury (i.e., von Willebrand factor, claudin-5), inflammation (i.e., fibrinogen, high mobility group box protein 1), and oxidative stress (i.e., 4-hydroxynoneal). In females, BLBP levels were significantly decreased at 2 days post-SRC compared with their pre-season baseline; however, area under the receiver operating characteristic curve (AUROC) analysis found that BLBP was unable to distinguish between SRC and controls. In males, AUROC analysis revealed a statistically significant change at 2 days post-SRC in the serum levels of 4-hydroxynoneal, however the associated AUROC value (0.6373) indicated little clinical utility for this biomarker in distinguishing SRC from controls. There were no other statistically significant findings. These results indicate that the serum biomarkers tested in this study hold little clinical value in the management of SRC at 2, 6, and 13 days post-injury.
与运动相关的脑震荡(SRC)相关的临床决策具有挑战性,因为 SRC 症状具有异质性,并且目前依赖于主观的自我报告症状测量。能够诊断 SRC 并确定恢复情况的敏感和客观方法将有助于临床管理,并且有证据表明 SRC 会引起循环蛋白生物标志物的变化,表明神经轴突损伤。然而,与 SRC 相关的其他病理生物学反应相关的潜在血液生物标志物仍了解甚少。因此,在这里,我们分析了来自澳大利亚足球联赛中受脑震荡影响的(男性=30;女性=9)和未受脑震荡影响的(男性=74;女性=27)业余运动员的血液样本,这些样本是在赛季前(即基线)和 SRC 后 2、6 和 13 天采集的,以确定与神经胶质(即脑脂质结合蛋白[BLBP];富含星形胶质细胞的磷酸蛋白 15)和脑血管损伤(即血管性血友病因子,claudin-5)、炎症(即纤维蛋白原、高迁移率族蛋白 1)和氧化应激(即 4-羟基壬烯醛)相关的血清生物标志物的时间依赖性变化。在女性中,与赛季前基线相比,SRC 后 2 天 BLBP 水平显著降低;然而,接收器操作特征曲线(AUROC)分析发现 BLBP 无法区分 SRC 和对照组。在男性中,AUROC 分析显示,SRC 后 2 天血清 4-羟基壬烯醛水平发生了统计学上的显著变化,然而相关的 AUROC 值(0.6373)表明该生物标志物在区分 SRC 和对照组方面的临床应用价值有限。没有其他统计学意义的发现。这些结果表明,在损伤后 2、6 和 13 天,本研究中测试的血清生物标志物在 SRC 的管理中几乎没有临床价值。