Biomarkers for the clinical differential diagnosis of traumatic brain injury

Abstract

Background Traumatic brain injury(TBI), as one of the leading causes of death and disability in young people, laid a huge economic and healthcare burden on our society. But lack of biomarkers to evaluate the severity of TBI poses challenges to effectively treat this disease, therefore, the prognosis of TBI is unpredictable. Objective To review studies in examining trauma-related molecules in body fluid of TBI patients, and analyzing the relationship of individual molecules with pathological alterations, correct diagnosis, therapeutic strategies, and varying prognosis. Content This paper summarizes currently available biomarkers associated with the clinical prognosis of TBI. Glial fibrillary acidic protein(GFAP) is a biomarker for primary brain injury, and in combination with S100β, it is valuable to predict the prognosis of TBI. The increase of the levels of ubiquitin c-terminal hydrolase-L1(UCHL1) and α-Ⅱ spectrin breakdown product(SBDP) can improve the identification of the severity of brain injury and the prognosis of TBI. Neurofilaments(NFs), S100β, GFAP, and UCHL1 are useful to define local or disseminated brain injury. The levels of C-Tau, neuron-specific enolase(NSE), GFAP, and SBDPs may be associated with the increase of intracranial pressure. Further investigations should be conducted to confirm the roles of some molecules, such as miRNAs, fatty acid binding proteins (FABPs), C-reactive protein(CRP), and matrix metalloproteinase-2 (MMP-2), as biomarkers of TBI. Trend The combination of multiple abovementioned biomarkers, although lack of specificity, are helpful for the diagnosis of TBI. Integrating these information with other clinical examinations, such as psychological assay, GLAS score, and computerized topography, may improve the diagnosis of TBI, and provide valuable basis for designing effective therapeutic strategies. Key words: Traumatic brain injury; Biomarkers