Department of Forensic Medicine, Center for Biostructure Research, Medical University of Warsaw, Oczki 1, 02-007, Warsaw, Poland.
Department of Neurosurgery, Dietrich-Bonhoeffer-Klinikum, Salvador-Allende-Straße 30, 17036, Neubrandenburg, Germany.
Int J Legal Med. 2023 Sep;137(5):1441-1452. doi: 10.1007/s00414-023-02990-7. Epub 2023 Jun 5.
Currently available epidemiological data shows that traumatic brain injury (TBI) represents one of the leading causes of death that is associated with medico-legal practice, including forensic autopsy, criminological investigation, and neuropathological examination. Attention focused on TBI research is needed to advance its diagnostics in ante- and post-mortem cases with regard to identification and validation of novel biomarkers. Recently, several markers of neuronal, astroglial, and axonal injury have been explored in various biofluids to assess the clinical origin, progression, severity, and prognosis of TBI. Despite clinical usefulness, understanding their diagnostic accuracy could also potentially help translate them either into forensic or medico-legal practice, or both. The aim of this study was to evaluate post-mortem pro-BDNF, NSE, UCHL1, GFAP, S100B, SPTAN1, NFL, MAPT, and MBP levels in serum and urine in TBI cases. The study was performed using cases (n = 40) of fatal head injury and control cases (n = 20) of sudden death. Serum and urine were collected within ∼ 24 h after death and compared using ELISA test. In our study, we observed the elevated concentration levels of GFAP and MAPT in both serum and urine, elevated concentration levels of S100B and SPTAN1 in serum, and decreased concentration levels of pro-BDNF in serum compared to the control group. The obtained results anticipate the possible implementation of performed assays as an interesting tool for forensic and medico-legal investigations regarding TBI diagnosis where the head injury was not supposed to be the direct cause of death.
目前的流行病学数据表明，创伤性脑损伤（TBI）是与法医学实践相关的主要死亡原因之一，包括法医解剖、犯罪学调查和神经病理学检查。需要关注 TBI 研究，以推进其在生前和死后病例中的诊断，包括鉴定和验证新的生物标志物。最近，已经在各种生物流体中探索了几种神经元、星形胶质细胞和轴突损伤的标志物，以评估 TBI 的临床起源、进展、严重程度和预后。尽管具有临床实用性，但了解其诊断准确性也可能有助于将其转化为法医学或医学法律实践，或者两者兼而有之。本研究旨在评估 TBI 病例血清和尿液中 pro-BDNF、NSE、UCHL1、GFAP、S100B、SPTAN1、NFL、MAPT 和 MBP 的死后水平。该研究使用了 40 例致命性头部损伤病例（病例组）和 20 例突然死亡的对照病例（对照组）。死后约 24 小时内采集血清和尿液，并使用 ELISA 试验进行比较。在我们的研究中，我们观察到血清和尿液中 GFAP 和 MAPT 的浓度升高，血清中 S100B 和 SPTAN1 的浓度升高，而血清中 pro-BDNF 的浓度降低与对照组相比。获得的结果预示着所进行的测定可能作为法医和医学法律调查中 TBI 诊断的一个有趣工具得到实施，前提是头部损伤不是直接死亡原因。
