Protein levels may predict survival outcomes following brain injury
A recent study suggests that high levels of certain proteins are predictive of poor patient outcome following traumatic brain injury.
Traumatic brain injury (TBI), resulting from a blow or bump to the head, often leads to impaired brain function. There is a high mortality rate associated with TBI; however, survival is possible, highlighting the need for effective biomarkers to direct treatment options. Researchers from Michigan Medicine (MI, US), the University of California San Francisco (CA, US) and the University of Pennsylvania (PA, US) have discovered a way to predict patient outcome following TBI by using blood tests to screen for high levels of proteins expressed in the brain, GFAP and UCH-L1, found to be predictive of death and severe injury.
The research team utilized 1700 blood samples from TBI patients on the day of their injury. The study built upon the previous approval of the use of GFAP and UCH-L1 levels in determining whether a CT scan was required, by screening for these potential biomarkers in the blood samples and evaluating their association with TBI outcome.
Protein levels were measured, and levels were compared with the status of the patient 6 months following injury. The findings revealed that risk of death during the 6 months following TBI was 23 times higher in individuals with GFAP levels in the top compared with the bottom 20th percentiles. Similarly, comparing UCH-L1 levels revealed that risk of death was 63 times greater during this 6-month period.
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Geoffrey Manley (University of California San Francisco) stated: “Modern trauma care can result in good outcomes in what we had once believed were non-survivable injuries. These blood tests are both diagnostic and prognostic, as well as easy to administer, safe and inexpensive.”
These findings, identifying high levels of GFAP and UCH-L1 proteins as indicative of poor patient outcome following traumatic brain injury, may aid in creating patient-specific treatment avenues, therefore increasing chance of recovery if possible.
“Early and accurate prediction of TBI outcomes will help clinicians gauge how severe a brain injury is and inform how best to counsel family members about care for their loved ones with brain injury and what to expect with regards to their recovery. It will also help researchers more precisely target promising TBI therapeutics to the right TBI patients,” commented Frederick Korley (University of Michigan Medical School).
The research team recognize that further knowledge is required to establish if these biomarkers are effective in predicting poor outcomes in mild cases of TBI. Korley reported that “as a next step, the TRACK-TBI team is planning a clinical trial that will examine the efficacy of promising therapeutic agents that may help traumatic brain injury patients recover quickly. As part of this clinical trial, these biomarkers will be used as an objective method for selecting the right patients to enroll in this trial. We will also use these biomarkers to monitor individual patient response to these promising therapeutics.”