Neuroinflammatory Biomarkers for Traumatic Brain Injury Diagnosis and Prognosis: A TRACK-TBI Pilot Study

Neuroinflammatory Biomarkers for Traumatic Brain Injury Diagnosis and Prognosis: A TRACK-TBI Pilot Study

The relationship between systemic inflammation and secondary injury in traumatic brain injury (TBI) is complex. We investigated associations between inflammatory markers and clinical confirmation of TBI diagnosis and prognosis. The prospective TRACK-TBI Pilot (Transforming Research and Clinical Know...

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Bibliographic Details
Main Authors: John K. Yue, Firas H. Kobeissy, Sonia Jain, Xiaoying Sun, Ryan R.L. Phelps, Frederick K. Korley, Raquel C. Gardner, Adam R. Ferguson, J. Russell Huie, Andrea L.C. Schneider, Zhihui Yang, Haiyan Xu, Cillian E. Lynch, Hansen Deng, Miri Rabinowitz, Mary J. Vassar, Sabrina R. Taylor, Pratik Mukherjee, Esther L. Yuh, Amy J. Markowitz, Ava M. Puccio, David O. Okonkwo, Ramon Diaz-Arrastia, Geoffrey T. Manley, Kevin K.W. Wang, Collaboration group, Neeraj Badjatia, Brandon Foreman, Shankar Gopinath, Ramesh Grandhi, Ruchira M. Jha, Hester F. Lingsma, Christopher Madden, Debbie Y. Madhok, Michael A. McCrea, Randall Merchant, Lindsay D. Nelson, Laura B. Ngwenya, Claudia S. Robertson, Richard B. Rodgers, Gabriela G. Satris, David M. Schnyer, Alex B. Valadka, Thomas A. van Essen, Ross Zafonte
Format: Article
Language:English
Published: Mary Ann Liebert 2023-03-01
Series:Neurotrauma Reports
Subjects:
acute phase reactant
alarmin
cytokine
neuroinflammation
prognosis
traumatic brain injury
Online Access:https://www.liebertpub.com/doi/full/10.1089/NEUR.2022.0060
Description
Summary:The relationship between systemic inflammation and secondary injury in traumatic brain injury (TBI) is complex. We investigated associations between inflammatory markers and clinical confirmation of TBI diagnosis and prognosis. The prospective TRACK-TBI Pilot (Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot) study enrolled TBI patients triaged to head computed tomography (CT) and received blood draw within 24?h of injury. Healthy controls (HCs) and orthopedic controls (OCs) were included. Thirty-one inflammatory markers were analyzed from plasma. Area under the receiver operating characteristic curve (AUC) was used to evaluate discriminatory ability. AUC >0.7 was considered acceptable. Criteria included: TBI diagnosis (vs. OC/HC); moderate/severe vs. mild TBI (Glasgow Coma Scale; GCS); radiographic TBI (CT positive vs. CT negative); 3- and 6-month Glasgow Outcome Scale-Extended (GOSE) dichotomized to death/greater relative disability versus less relative disability (GOSE 1?4/5?8); and incomplete versus full recovery (GOSE <8/?=?8). One-hundred sixty TBI subjects, 28 OCs, and 18 HCs were included. Markers discriminating TBI/OC: HMGB-1 (AUC?=?0.835), IL-1b (0.795), IL-16 (0.784), IL-7 (0.742), and TARC (0.731). Markers discriminating GCS 3?12/13?15: IL-6 (AUC?=?0.747), CRP (0.726), IL-15 (0.720), and SAA (0.716). Markers discriminating CT positive/CT negative: SAA (AUC?=?0.767), IL-6 (0.757), CRP (0.733), and IL-15 (0.724). At 3 months, IL-15 (AUC?=?0.738) and IL-2 (0.705) discriminated GOSE 5?8/1?4. At 6 months, IL-15 discriminated GOSE 1?4/5?8 (AUC?=?0.704) and GOSE <8/?=?8 (0.711); SAA discriminated GOSE 1?4/5?8 (0.704). We identified a profile of acute circulating inflammatory proteins with potential relevance for TBI diagnosis, severity differentiation, and prognosis. IL-15 and serum amyloid A are priority markers with acceptable discrimination across multiple diagnostic and outcome categories. Validation in larger prospective cohorts is needed. ClinicalTrials.gov Registration: NCT01565551
ISSN:2689-288X

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