H-FABP: A new biomarker to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury

Lagerstedt, Linnéa; Egea-Guerrero, Juan José; Bustamante, Alejandro; Montaner, Joan; Rodríguez-Rodríguez, A.; Rahal, Amir El; Turck, Natacha; Quintana, Manuel; García-Armengol, Roser; Prica, Carmen Melinda; Andereggen, E; Rinaldi, Lara; Sarrafzadeh, Asita; Schaller, Karl; Sanchez, Jean‐Charles

doi:10.1371/journal.pone.0175572

Cited by 36 publications

(37 citation statements)

References 34 publications

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“…[ 32 , 35 ] Here, S100B’s performance was also shown to vary between younger and elderly patients. [ 9 ] IL-10, however, retained a similar high specificity independent of age. These results suggest that measuring levels of the IL-10 protein could be interesting clinically for the triage of patients requiring a CT-scan, with no restrictions on time or the patient’s age.…”

Section: Discussionmentioning

confidence: 91%

“…Not all patients suffering from mTBI seek immediate clinical help, thereby increasing the time between trauma and blood sampling. [ 9 ] The markers’ performances were therefore evaluated on patients admitted to hospital within 24 h of their trauma event. This raised the cohort population to 207 mTBI patients, of whom 29 (14%) were CT-positive and 178 (86%) were CT-negative ( S3 Table ).…”

Section: Resultsmentioning

confidence: 99%

“…This study’s criteria for inclusion and exclusion have been described elsewhere. [ 9 ] The main inclusion criteria were a diagnosis of mTBI, a GCS score of 15 at hospital admission and at least one of the following symptoms: headache, nausea or vomiting, loss of consciousness (< 30 min) and amnesia (< 24 h). Participating patients gave a blood sample at hospital admission and underwent a CT scan within 24 h of their trauma event.…”

Section: Methodsmentioning

confidence: 99%

“…S100B, UCHL1, GFAP and H-FABP. [ 9 – 20 ] Nevertheless, as yet, the FDA has not validated any for clinical use. [ 5 , 21 , 22 ] Increased concentrations of GFAP, for example, are due to leakage from injured astroglia damaged at the primary injury stage.…”

Section: Introductionmentioning

confidence: 99%

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Early measurement of interleukin-10 predicts the absence of CT scan lesions in mild traumatic brain injury

et al. 2018

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Traumatic brain injury is a common event where 70%–90% will be classified as mild TBI (mTBI). Among these, only 10% will have a brain lesion visible via CT scan. A triage biomarker would help clinicians to identify patients with mTBI who are at risk of developing a brain lesion and require a CT scan. The brain cells damaged by the shearing, tearing and stretching of a TBI event set off inflammation cascades. These cause altered concentrations of a high number of both pro-inflammatory and anti-inflammatory proteins. This study aimed to discover a novel diagnostic biomarker of mTBI by investigating a broad panel of inflammation biomarkers and their capacity to correctly identify CT-positive and CT-negative patients. Patients enrolled in this study had been diagnosed with mTBI, had a GCS score of 15 and suffered from at least one clinical symptom. There were nine patients in the discovery group, 45 for verification, and 133 mTBI patients from two different European sites in the validation cohort. All patients gave blood samples, underwent a CT scan and were dichotomised into CT-positive and CT-negative groups for statistical analyses. The ability of each protein to classify patients was evaluated with sensitivity set at 100%. Three of the 92 inflammation proteins screened—MCP-1, MIP-1alpha and IL-10 –were further investigated in the verification group, and at 100% sensitivity their specificities reached 7%, 0% and 31%, respectively. IL-10 was validated on a larger cohort in comparison to the most studied mTBI diagnostic triage protein to date, S100B. Levels of both proteins were significantly higher in CT-positive than in CT-negative patients (p < 0.001). S100B’s specificity at 100% sensitivity was 18% (95% CI 10.8–25.2), whereas IL-10 reached a specificity of 27% (95% CI 18.9–35.1). These results showed that IL-10 might be an interesting and clinically useful diagnostic tool, capable of differentiating between CT-positive and CT-negative mTBI patients.

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Section: Discussionmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early measurement of interleukin-10 predicts the absence of CT scan lesions in mild traumatic brain injury

et al. 2018

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“…6,7,8 The concern with the low rate of positive ndings on CT scans are that the scans are not risk free due to the radiation exposure. 9,10 In addition, they confer a signi cant cost to the health care system not only from the radiology costs, but those related to ED waiting times and LO.S 11 This variability and escalating CT use has led to the development of clinical guidelines and pathways to aid decision making. These tools include the Canadian CT head rule or the New Orleans Criteria 12 which combine Glasgow Coma Scores (GCS) with other clinical risk factors to determine which patients should undergo imaging.…”

Section: Introductionmentioning

confidence: 99%

Acute traumatic brain injury presentations and the use of head CT scans in the Emergency Department

Rogan¹,

Patel²,

Birdling³

et al. 2020

Preprint

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Objective: The use of CT head scanning for traumatic brain injury (TBI) is a vital diagnostic tool, guided by risk stratification tools. This study aims to review the use of CT head scans for TBI in two Australasian Emergency Departments (ED) in New Zealand.Methods: Retrospective observational design of patients referred for head CT from ED to exclude a significant intracranial injury between 1st September 2018 and 31st August 2019. Clinical data were collected regarding presenting patterns, identification of injuries on CT scan and adherence to CT guidelines.Results: Out of 425 cases reviewed, a clinically significant injury was identified in 41 (10%) patients. Patients who reported loss (32% vs 20% p < 0.05) or possible loss of consciousness (34% vs 22% p < 0.05) and had GCS < 13 (17% vs 8%, p < 0.05) or focal neurology (10% vs 3%, p < 0.05) were more likely to have a significantly intracranial injury on CT. Interestingly, 17 (41%) patients with significant injury were GCS 15 with no focal neurology. NICE guidelines were adhered to in 364 (86%) patients. In the 14% of cases that did not meet guideline criteria, all CT head scans were negative.Conclusion: CT head scans are a valuable tool in TBI and guidelines successfully identify those with significant intracranial injuries. However, the rate of significant injury for the total population requiring head CT remains low, with over 90% of head CTs in the population normal, despite high guideline compliance perhaps identifying a role for novel objective tests in ED guidelines internationally.

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Cerebrospinal fluid levels of fatty acid–binding protein 3 are associated with likelihood of amyloidopathy in cognitively healthy individuals

Dhiman

Villemagne

Fowler

et al. 2022

Alz & Dem Diag Ass & Dis Mo

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Introduction Fatty acid–binding protein 3 (FABP3) is a biomarker of neuronal membrane disruption, associated with lipid dyshomeostasis—a notable Alzheimer's disease (AD) pathophysiological change. We assessed the association of cerebrospinal fluid (CSF) FABP3 levels with brain amyloidosis and the likelihood/risk of developing amyloidopathy in cognitively healthy individuals. Methods FABP3 levels were measured in CSF samples of cognitively healthy participants, > 60 years of age ( n = 142), from the Australian Imaging, Biomarkers & Lifestyle Flagship Study of Ageing (AIBL). Results FABP3 levels were positively associated with baseline brain amyloid beta (Aβ) load as measured by standardized uptake value ratio (SUVR, standardized β = 0.22, P = .009) and predicted the change in brain Aβ load (standardized β = 0.32, P = .004). Higher levels of CSF FABP3 (above median) were associated with a likelihood of amyloidopathy (odds ratio [OR] 2.28, 95% confidence interval [CI] 1.12 to 4.65, P = .023). Discussion These results support inclusion of CSF FABP3 as a biomarker in risk‐prediction models of AD.

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H-FABP: A new biomarker to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury

Cited by 36 publications

References 34 publications

Early measurement of interleukin-10 predicts the absence of CT scan lesions in mild traumatic brain injury

Early measurement of interleukin-10 predicts the absence of CT scan lesions in mild traumatic brain injury

Acute traumatic brain injury presentations and the use of head CT scans in the Emergency Department

Cerebrospinal fluid levels of fatty acid–binding protein 3 are associated with likelihood of amyloidopathy in cognitively healthy individuals

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