Artikel
Detection of cerebral lesions in mild traumatic brain injury – plasma Nucleoside Diphosphate kinase A (NDKA) as plasma biomarker
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Autoren
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Asita Sarrafzadeh
- Division of Neurosurgery, Geneva Neuroscience Center, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
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Linnéa Lagerstedt
- Department of Human Protein Sciences, Faculty of Medicine, Geneva, Switzerland
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Natacha Turck
- Department of Human Protein Sciences, Faculty of Medicine, Geneva, Switzerland
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Elisabeth Andereggen
- Emergency Center, Geneva University Hospitals, Geneva, Switzerland; Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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Alexandre Bulla
- Department of Genetic and Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
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Karl Schaller
- Division of Neurosurgery, Geneva Neuroscience Center, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
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Jean-Charles Sanchez
- Department of Human Protein Sciences, Faculty of Medicine, Geneva, Switzerland
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: Computer tomography scan (CT) is used for the detection of cerebral lesions after mild traumatic brain injury (mTBI, Glasgow Coma Score 13-15). However, CT scans are associated with radiation, expensive and may not detect lesions such as diffuse axonal injury. Despite several years of research on blood biomarkers, no alternative to the CT is yet available. The most promising biomarker remains S100b with specificity around 30% and sensitivity close to 100%. In brain injury models, the proteins GSTP1 (GSTP1 glutathione S-transferase pi 1), NDKA and H-FABP (heart-type fatty acid binding protein) have previously been discussed as potential biomarkers by a proteomics-based strategy. Here, we investigate whether these proteins, in comparison to S100b, could improve the rule-out of mTBI patients and thereby avoid unnecessary CT-scans in the future.
Method: The plasma levels of S100b, GSTP1, NDKA and H-FABP were measured by immunoassays on 56 mTBI patients (56 ± 23 years) recruited within the first 6h after trauma (ongoing prospective study, ethical vote obtained). The patients were dichotomized into CT-negative and CT-positive groups for statistical analyses. The predictive performance of these biomarkers was established using Mann-Whitney U tests and ROC curves.
Results: Out of the four proteins, only S100B and NDKA were significantly increased in CT positive patients (p<0.05). Interestingly, NDKA was capable of reaching 46% of specificity for 100% sensitivity.
Conclusions: The present pilot study demonstrates that NDKA might be a useful plasma biomarker to detect cerebral lesions and to reduce the number of unnecessary CT-scans in mTBI patients.
