Development of a Traumatic Brain Injury Assessment Score using Novel Biomarkers Discovered Through Autoimmune Profiling
Abstract
Purpose: There is no effective method to assess mild traumatic brain injury (mTBI) objectively. Brain-specific autoantibodies could be used to identify proteins that will serve as circulating biomarkers for the assessment of mTBI. Design: Prospective between subjects experimental design Methods: Autoimmune profiling was used to identify novel brain proteins targeted by TBI-induced autoantibodies to determine if these proteins contribute to a circulating biomarker signature useful in the diagnosis and assessment of mTBI. Immunosorbent electrochemiluminescent assays were developed for one of the discovered novel biomarker proteins (peroxiredoxin 6) and six established neuropathology biomarkers. Sample: Emergency room patient blood samples were obtained from two separate ongoing collaborating studies (Cohort 1: mild to moderate TBI; Cohort 2: moderate to severe TBI). Subjects were adults admitted with a diagnosis of head injury. Admission plasma samples were obtained from Cohort 1 (n = 154) and 2-7 days post-injury. Cohort 2 (n = 106) had plasma samples obtained at admission, 6, 12, and 24 hours post-injury. Both cohorts were compared to an individualized control group. Analysis: The study employed multivariate analysis of variance, utilizing seven dependent variables against one, two-level (control: injured) independent variable. Findings: Compared to controls the mean plasma values of 5 of the candidate TBI biomarker proteins in Cohort 1and Cohort 2 were significantly elevated at (admission and 2-7 days post-injury) and (6, and 12 hours post-injury) respectively. The summation of the fold-changes observed in the plasma levels of 5 biomarkers differentiated control samples from both the mild and the severe brain injured with scores of 5, 17, 32 respectively. Implications for Military Nursing: Creating a TBI assessment score for mTBI provides an opportunity to diagnose an endemic condition in our service members. Accurate and timely diagnosis of mTBI addresses a fundam
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 15, 2014
- Accession Number
- ADA616466
Entities
People
- John E. Buonora
Organizations
- Henry M. Jackson Foundation for the Advancement of Military Medicine