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Update on protein biomarkers in traumatic brain injury with emphasis on clinical use in adults and pediatrics

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Abstract

Purpose

This review summarizes protein biomarkers in mild and severe traumatic brain injury in adults and children and presents a strategy for conducting rationally designed clinical studies on biomarkers in head trauma.

Methods

We performed an electronic search of the National Library of Medicine’s MEDLINE and Biomedical Library of University of Pennsylvania database in March 2008 using a search heading of traumatic head injury and protein biomarkers. The search was focused especially on protein degradation products (spectrin breakdown product, c-tau, amyloid-β1–42) in the last 10 years, but recent data on “classical” markers (S-100B, neuron-specific enolase, etc.) were also examined.

Results

We identified 85 articles focusing on clinical use of biomarkers; 58 articles were prospective cohort studies with injury and/or outcome assessment.

Conclusions

We conclude that only S-100B in severe traumatic brain injury has consistently demonstrated the ability to predict injury and outcome in adults. The number of studies with protein degradation products is insufficient especially in the pediatric care. Cohort studies with well-defined end points and further neuroproteomic search for biomarkers in mild injury should be triggered. After critically reviewing the study designs, we found that large homogenous patient populations, consistent injury, and outcome measures prospectively determined cutoff values, and a combined use of different predictors should be considered in future studies.

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Acknowledgements

This work was supported by the Hungarian Science Funds (OTKA T048724/2005 and OTKA 72240). The authors wish to thank to Joel H. Greenberg Ph.D., Katalin Kariko Ph.D., and Brian Edlow M.D. for critical review of this manuscript.

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  1. Department of Neurosurgery, University of Pécs, Rét u. 2., 7623, Pécs, Hungary

    Erzsébet Kövesdi, Péter Bukovics, Orsolya Farkas, József Pál, Endre Czeiter, Dóra Szellár, Tamás Dóczi & András Büki

  2. Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA

    János Lückl

  3. Neurobiology Research Group of the Hungarian Academy of Sciences, Pécs, Hungary

    Péter Bukovics

  4. Department of Neurology, University of Pécs, Pécs, Hungary

    Sámuel Komoly

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Kövesdi, E., Lückl, J., Bukovics, P. et al. Update on protein biomarkers in traumatic brain injury with emphasis on clinical use in adults and pediatrics. Acta Neurochir 152, 1–17 (2010). https://doi.org/10.1007/s00701-009-0463-6

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