Research Reports - A new panel of blood biomarkers for the diagnosis of mild traumatic brain injury/concussion

J Neurotrauma. 2015 Jun 11

Shan R(1), Szmydynger-Chodobska J(1), Warren OU(2), Mohammad F(3), Zink BJ(2),
Chodobski A(1)

No routine tests currently exist to objectively diagnose mild traumatic brain
injury (mTBI)/concussion. Previously reported biomarkers for mTBI represented
proteins released from damaged neurons or glia. However, low levels of these
proteins, and/or the complexity of assays used for their detection, limits
implementation of these biomarkers in routine practice. Here, we sought to
identify proteins whose synthesis is altered post-mTBI and whose blood levels
could be measured using standard immunoassays. Adult patients sustaining a
concussion within the past 24 h were enrolled. Controls were uninjured subjects
and patients with orthopedic injury (OI). Four candidate biomarkers were
identified: copeptin; galectin 3 (LGALS3); matrix metalloproteinase 9 (MMP9); and
occludin (OCLN). A 3.4-fold decrease (p<0.0001) in plasma concentration of
copeptin was found in mTBI patients within 8 h after accident, compared to
uninjured controls. Plasma levels of LGALS3, MMP9, and OCLN increased 3.6- to
4.5-fold (p<0.0001) within the same time frame postinjury. Levels of at least two
biomarkers were altered beyond their respective cut-off values in 90% of mTBI
patients, whereas in none of uninjured controls were levels of two biomarkers
simultaneously changed. A positive correlation (r=0.681; p<0.001) between plasma
levels of LGALS3 and OCLN was also found in mTBI patients, whereas in OI patients
or uninjured subjects, these variables did not correlate. This panel of
biomarkers discerns, with high accuracy, patients with isolated concussion from
uninjured individuals within the first 8 h after accident. These biomarkers can
also aid in diagnosing concussion in the presence of OI.

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