A. Tefr Faridová, Department of Pathophysiology, Second Faculty of Medicine, Charles University, Prague 5, Czech Republic.
Physiol Res. 2023 Dec 29;72(S5):S461-S474. doi: 10.33549/physiolres.935214.
Brain injury is a multifaceted condition arising from nonspecific damage to nervous tissue. The resulting cognitive developmental impairments reverberate through patients' lives, affecting their families, and even the broader economic landscape. The significance of early brain injury detection lies in its potential to stave off severe consequences and enhance the effectiveness of tailored therapeutic interventions. While established methods like neuroimaging and neurophysiology serve as valuable diagnostic tools, their demanding nature restricts their accessibility, particularly in scenarios such as small hospitals, nocturnal or weekend shifts, and cases involving unstable patients. Hence, there is a pressing need for more accessible and efficient diagnostic avenues. Among the spectrum of brain injuries, hypoxic-ischemic encephalopathy stands out as a predominant affliction in the pediatric population. Diagnosing brain injuries in newborns presents challenges due to the subjective nature of assessments like Apgar scores and the inherent uncertainty in neurological examinations. In this context, methods like magnetic resonance and ultrasound hold recommendations for more accurate diagnosis. Recognizing the potential of serum biomarkers derived from blood samples, this paper underscores their promise as a more expedient and resource-efficient means of assessing brain injuries. The review compiles current insights into serum biomarkers, drawing from experiments conducted on animal models as well as human brain pathologies. The authors aim to elucidate specific characteristics, temporal profiles, and the available corpus of experimental and clinical data for serum biomarkers specific to brain injuries. These include neuron-specific enolase (NSE), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), S100 calcium-binding protein beta (S100B), glial fibrillary acidic protein (GFAP), and high-mobility-group-protein-box-1 (HMGB1). This comprehensive endeavor contributes to advancing the understanding of brain injury diagnostics and potential avenues for therapeutic intervention.
脑损伤是一种由神经组织非特异性损伤引起的多方面疾病。由此导致的认知发育障碍会在患者的生活中产生深远影响,不仅对患者自身,还会波及他们的家庭,甚至更广泛的经济领域。早期脑损伤检测的重要意义在于它有可能避免严重后果,并增强针对性治疗干预的效果。虽然像神经影像学和神经生理学这样的已有方法是有价值的诊断工具,但它们的复杂性限制了其可及性,尤其是在小医院、夜间或周末轮班、涉及不稳定患者的情况下。因此,我们迫切需要更便捷、更高效的诊断途径。在各种脑损伤中,缺氧缺血性脑病是儿科人群中主要的疾病。由于评估方法(如 Apgar 评分)的主观性以及神经检查的固有不确定性,新生儿脑损伤的诊断存在挑战。在这种情况下,磁共振和超声等方法被推荐用于更准确的诊断。鉴于血清生物标志物源自血液样本的潜力,本文强调了它们作为评估脑损伤更快捷、资源更高效的手段的前景。本综述汇集了当前关于血清生物标志物的见解,这些见解来自于动物模型实验和人类脑病理学研究。作者旨在阐明特定的特征、时间图谱以及针对脑损伤的特定血清生物标志物的现有实验和临床数据。这些标志物包括神经元特异性烯醇化酶(NSE)、泛素羧基末端水解酶 L1(UCH-L1)、S100 钙结合蛋白β(S100B)、胶质纤维酸性蛋白(GFAP)和高迁移率族蛋白 B1(HMGB1)。这项全面的研究有助于推进脑损伤诊断学的理解,并为治疗干预提供潜在途径。