The Levels of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 During the First Week After a Traumatic Brain Injury: Correlations With Clinical and Imaging Findings

Jussi Posti (Corresponding Author), Riikka S.K. Takala, Hilkka Runtti, Virginia F. Newcombe, Joanne Outtrim, Ari J. Katila, Janek Frantzén, Henna Ala-Seppälä, Jonathan P. Coles, Md. Iftakher Hossain, Anna Kyllönen, Henna-Riikka Maanpää, Jussi Tallus, Peter J. Hutchinson, Mark van Gils, David K. Menon, Olli Tenovuo

    Research output: Contribution to journalArticleScientificpeer-review

    37 Citations (Scopus)

    Abstract

    BACKGROUND: Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase- L1 (UCH-L1) are promising biomarkers of traumatic brain injury (TBI). OBJECTIVE: We investigated the relation of the GFAP and UCH-L1 levels to the severity of TBI during the first week after injury. METHODS: Plasma UCH-L1 and GFAP were measured from 324 consecutive patients with acute TBI and 81 control subject enrolled in a 2-center prospective study. The baseline measures included initial Glasgow Coma Scale (GCS), head computed tomographic (CT) scan at admission, and blood samples for protein biomarkers that were collected at admission and on days 1, 2, 3, and 7 after injury. RESULTS: Plasma levels of GFAP and UCH-L1 during the first 2 days after the injury strongly correlated with the initial severity of TBI as assessed with GCS. Additionally, levels of UCH-L1 on the seventh day after the injury were significantly related to the admission GCS scores. At admission, both biomarkers were capable of distinguishing mass lesions from diffuse injuries in CT, and the area under the curve of the receiver-operating characteristic curve for prediction of any pathological finding in CT was 0.739 (95% confidence interval, 0.636-0.815) and 0.621 (95% confidence interval, 0.517-0.713) for GFAP and UCH-L1, respectively. CONCLUSION: These results support the prior findings of the potential role of GFAP and UCH-L1 in acute-phase diagnostics of TBI. The novel finding is that levels of GFAP and UCH-L1 correlated with the initial severity of TBI during the first 2 days after the injury, thus enabling a window for TBI diagnostics with latency.
    Original languageEnglish
    Pages (from-to)456-464
    JournalNeurosurgery
    Volume79
    Issue number3
    DOIs
    Publication statusPublished - 2016
    MoE publication typeA1 Journal article-refereed

    Keywords

    • biomarker
    • GFAP
    • Severity
    • traumatic brain injury
    • UCH-L1

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