Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury

Jussi P. Posti; Iftakher Hossain; Riikka S.K. Takala; Hilkka Liedes; Virginia Newcombe; Joanne Outtrim; Ari J. Katila; Janek Frantzén; Henna Ala-Seppälä; Jonathan P. Coles; Anna Kyllönen; Henna Riikka Maanpää; Jussi Tallus; Peter J. Hutchinson; Mark Van Gils; David K. Menon; Olli Tenovuo

doi:10.1089/neu.2016.4442

Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury

Jussi P. Posti, Iftakher Hossain, Riikka S.K. Takala, Hilkka Liedes, Virginia Newcombe, Joanne Outtrim, Ari J. Katila, Janek Frantzén, Henna Ala-Seppälä, Jonathan P. Coles, Anna Kyllönen, Henna Riikka Maanpää, Jussi Tallus, Peter J. Hutchinson, Mark Van Gils, David K. Menon, Olli Tenovuo

Research output: Contribution to journal › Article › Scientific › peer-review

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Abstract

Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been studied as potential biomarkers of mild traumatic brain injury (mTBI). We report the levels of GFAP and UCH-L1 in patients with acute orthopedic injuries without central nervous system involvement, and relate them to the type of extracranial injury, head magnetic resonance imaging (MRI) findings, and levels of GFAP and UCH-L1 in patients with CT-negative mTBI. Serum UCH-L1 and GFAP were longitudinally measured from 73 patients with acute orthopedic injury on arrival and on days 1, 2, 3, 7 after admission, and on the follow-up visit 3-10 months after the injury. The injury types were recorded, and 71% patients underwent also head MRI. The results were compared with those found in patients with CT-negative mTBI (n = 93). The levels of GFAP were higher in patients with acute orthopedic trauma than in patients with CT-negative mTBI (p = 0.026) on arrival; however, no differences were found on the following days. The levels of UCH-L1 were not significantly different between these two groups at any measured point of time. Levels of GFAP and UCH-L1 were not able to distinguish patients with CT-negative mTBI from patients with orthopedic trauma. Patients with orthopedic trauma and high levels of UCH-L1 or GFAP values may be falsely diagnosed as having a concomitant mTBI, predisposing them to unwarranted diagnostics and unnecessary brain imaging. This casts a significant doubt on the diagnostic value of GFAP and UCH-L1 in cases with mTBI.

Original language	English
Pages (from-to)	1427-1438
Number of pages	12
Journal	Journal of Neurotrauma
Volume	34
Issue number	7
DOIs	https://doi.org/10.1089/neu.2016.4442
Publication status	Published - 1 Apr 2017
Externally published	Yes
Publication type	A1 Journal article-refereed

Funding

Acknowledgments This work was partially funded by the European Commission under the 7th Framework Programme (FP7-270259-TBIcare), personal Government's Special Financial Transfer tied to academic research in Health Sciences ( J.P.P. and R.S.K.T.), personal EVO funding and grant from Maire Taponen Foundation ( J.P.P.), Health Foundation/Academy of Medical Sciences Clinician Scientist Fellowship (V.N.), National Institute for Health Research (NIHR) Research Fellowship (P.J.H.) The authors thank research nurses Patricia Bertenyi and Satu Timlin for their valuable contribution to this study.

Keywords

biomarker
GFAP
orthopedic injury
TBI
UCH-L1

ASJC Scopus subject areas

Clinical Neurology

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10.1089/neu.2016.4442

Cite this

Posti, J. P., Hossain, I., Takala, R. S. K., Liedes, H., Newcombe, V., Outtrim, J., Katila, A. J., Frantzén, J., Ala-Seppälä, H., Coles, J. P., Kyllönen, A., Maanpää, H. R., Tallus, J., Hutchinson, P. J., Van Gils, M., Menon, D. K., & Tenovuo, O. (2017). Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury. Journal of Neurotrauma, 34(7), 1427-1438. https://doi.org/10.1089/neu.2016.4442

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abstract = "Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been studied as potential biomarkers of mild traumatic brain injury (mTBI). We report the levels of GFAP and UCH-L1 in patients with acute orthopedic injuries without central nervous system involvement, and relate them to the type of extracranial injury, head magnetic resonance imaging (MRI) findings, and levels of GFAP and UCH-L1 in patients with CT-negative mTBI. Serum UCH-L1 and GFAP were longitudinally measured from 73 patients with acute orthopedic injury on arrival and on days 1, 2, 3, 7 after admission, and on the follow-up visit 3-10 months after the injury. The injury types were recorded, and 71% patients underwent also head MRI. The results were compared with those found in patients with CT-negative mTBI (n = 93). The levels of GFAP were higher in patients with acute orthopedic trauma than in patients with CT-negative mTBI (p = 0.026) on arrival; however, no differences were found on the following days. The levels of UCH-L1 were not significantly different between these two groups at any measured point of time. Levels of GFAP and UCH-L1 were not able to distinguish patients with CT-negative mTBI from patients with orthopedic trauma. Patients with orthopedic trauma and high levels of UCH-L1 or GFAP values may be falsely diagnosed as having a concomitant mTBI, predisposing them to unwarranted diagnostics and unnecessary brain imaging. This casts a significant doubt on the diagnostic value of GFAP and UCH-L1 in cases with mTBI.",

keywords = "biomarker, GFAP, orthopedic injury, TBI, UCH-L1",

author = "Posti, {Jussi P.} and Iftakher Hossain and Takala, {Riikka S.K.} and Hilkka Liedes and Virginia Newcombe and Joanne Outtrim and Katila, {Ari J.} and Janek Frantz{\'e}n and Henna Ala-Sepp{\"a}l{\"a} and Coles, {Jonathan P.} and Anna Kyll{\"o}nen and Maanp{\"a}{\"a}, {Henna Riikka} and Jussi Tallus and Hutchinson, {Peter J.} and {Van Gils}, Mark and Menon, {David K.} and Olli Tenovuo",

note = "Funding Information: Acknowledgments This work was partially funded by the European Commission under the 7th Framework Programme (FP7-270259-TBIcare), personal Government's Special Financial Transfer tied to academic research in Health Sciences ( J.P.P. and R.S.K.T.), personal EVO funding and grant from Maire Taponen Foundation ( J.P.P.), Health Foundation/Academy of Medical Sciences Clinician Scientist Fellowship (V.N.), National Institute for Health Research (NIHR) Research Fellowship (P.J.H.) The authors thank research nurses Patricia Bertenyi and Satu Timlin for their valuable contribution to this study. Publisher Copyright: {\textcopyright} 2017, Mary Ann Liebert, Inc. 2017.",

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language = "English",

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Posti, JP, Hossain, I, Takala, RSK, Liedes, H, Newcombe, V, Outtrim, J, Katila, AJ, Frantzén, J, Ala-Seppälä, H, Coles, JP, Kyllönen, A, Maanpää, HR, Tallus, J, Hutchinson, PJ, Van Gils, M, Menon, DK & Tenovuo, O 2017, 'Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury', Journal of Neurotrauma, vol. 34, no. 7, pp. 1427-1438. https://doi.org/10.1089/neu.2016.4442

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T1 - Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury

AU - Posti, Jussi P.

AU - Hossain, Iftakher

AU - Takala, Riikka S.K.

AU - Liedes, Hilkka

AU - Newcombe, Virginia

AU - Outtrim, Joanne

AU - Katila, Ari J.

AU - Frantzén, Janek

AU - Ala-Seppälä, Henna

AU - Coles, Jonathan P.

AU - Kyllönen, Anna

AU - Maanpää, Henna Riikka

AU - Tallus, Jussi

AU - Hutchinson, Peter J.

AU - Van Gils, Mark

AU - Menon, David K.

AU - Tenovuo, Olli

N1 - Funding Information: Acknowledgments This work was partially funded by the European Commission under the 7th Framework Programme (FP7-270259-TBIcare), personal Government's Special Financial Transfer tied to academic research in Health Sciences ( J.P.P. and R.S.K.T.), personal EVO funding and grant from Maire Taponen Foundation ( J.P.P.), Health Foundation/Academy of Medical Sciences Clinician Scientist Fellowship (V.N.), National Institute for Health Research (NIHR) Research Fellowship (P.J.H.) The authors thank research nurses Patricia Bertenyi and Satu Timlin for their valuable contribution to this study. Publisher Copyright: © 2017, Mary Ann Liebert, Inc. 2017.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been studied as potential biomarkers of mild traumatic brain injury (mTBI). We report the levels of GFAP and UCH-L1 in patients with acute orthopedic injuries without central nervous system involvement, and relate them to the type of extracranial injury, head magnetic resonance imaging (MRI) findings, and levels of GFAP and UCH-L1 in patients with CT-negative mTBI. Serum UCH-L1 and GFAP were longitudinally measured from 73 patients with acute orthopedic injury on arrival and on days 1, 2, 3, 7 after admission, and on the follow-up visit 3-10 months after the injury. The injury types were recorded, and 71% patients underwent also head MRI. The results were compared with those found in patients with CT-negative mTBI (n = 93). The levels of GFAP were higher in patients with acute orthopedic trauma than in patients with CT-negative mTBI (p = 0.026) on arrival; however, no differences were found on the following days. The levels of UCH-L1 were not significantly different between these two groups at any measured point of time. Levels of GFAP and UCH-L1 were not able to distinguish patients with CT-negative mTBI from patients with orthopedic trauma. Patients with orthopedic trauma and high levels of UCH-L1 or GFAP values may be falsely diagnosed as having a concomitant mTBI, predisposing them to unwarranted diagnostics and unnecessary brain imaging. This casts a significant doubt on the diagnostic value of GFAP and UCH-L1 in cases with mTBI.

AB - Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) have been studied as potential biomarkers of mild traumatic brain injury (mTBI). We report the levels of GFAP and UCH-L1 in patients with acute orthopedic injuries without central nervous system involvement, and relate them to the type of extracranial injury, head magnetic resonance imaging (MRI) findings, and levels of GFAP and UCH-L1 in patients with CT-negative mTBI. Serum UCH-L1 and GFAP were longitudinally measured from 73 patients with acute orthopedic injury on arrival and on days 1, 2, 3, 7 after admission, and on the follow-up visit 3-10 months after the injury. The injury types were recorded, and 71% patients underwent also head MRI. The results were compared with those found in patients with CT-negative mTBI (n = 93). The levels of GFAP were higher in patients with acute orthopedic trauma than in patients with CT-negative mTBI (p = 0.026) on arrival; however, no differences were found on the following days. The levels of UCH-L1 were not significantly different between these two groups at any measured point of time. Levels of GFAP and UCH-L1 were not able to distinguish patients with CT-negative mTBI from patients with orthopedic trauma. Patients with orthopedic trauma and high levels of UCH-L1 or GFAP values may be falsely diagnosed as having a concomitant mTBI, predisposing them to unwarranted diagnostics and unnecessary brain imaging. This casts a significant doubt on the diagnostic value of GFAP and UCH-L1 in cases with mTBI.

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KW - GFAP

KW - orthopedic injury

KW - TBI

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Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury

Abstract

Funding

Keywords

ASJC Scopus subject areas

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