Serial Sampling of Serum Protein Biomarkers for Monitoring Human Traumatic Brain Injury Dynamics: A Systematic Review.
Serial Sampling of Serum Protein Biomarkers for Monitoring Human Traumatic Brain Injury Dynamics: A Systematic Review.
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DOI：
10.3389/fneur.2017.00300
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发表时间：
2017
影响因子：
3.4
通讯作者：
Nelson DW
中科院分区：
文献类型：
--
作者：
Thelin EP;Zeiler FA;Ercole A;Mondello S;Büki A;Bellander BM;Helmy A;Menon DK;Nelson DW
蛋白质S100 B，神经元特异性烯醇化酶（NSE），胶质细胞酸性蛋白（GFAP），泛素羧基末端水解酶L1（UCH-L1），和神经丝轻（NF-L）已连续采样的患者患有创伤性脑损伤（TBI）的血清中，以评估损伤的严重程度和组织的命运。我们回顾了TBI后这些蛋白质的血清水平动态的当前文献，并使用术语“有效半衰期”（t1/2）来描述血清中的“下降”率。通过在EMBASE、Medline和Scopus上的检索，我们寻找这些蛋白质在人TBI血清中连续采样的文章。我们排除了动物研究、只有一个样本的研究和没有神经放射学检查的研究。筛选后（10，389篇论文），纳入n = 122篇论文。蛋白S100 B（n = 66）和NSE（n = 27）是连续采样的两种最常见的生物标志物。对于严重TBI中的S100 B，大多数研究表明t1 - 2约为24 h，即使这些患者的极早期采样显示快速降低（1-2 h），但可能是非脑源性的。相比之下，NSE的t1/2更长，在严重TBI病例中为48至72小时。蛋白GFAP（n = 18）在严重TBI中似乎具有约24-48 h的t1/2。蛋白质UCH-L1（n = 9）在轻度TBI中的t1/2约为7 h，在重度TBI中约为10 h。这些蛋白质的频繁采样揭示了不同的轨迹，在具有不利结果的患者或发生继发性有害事件的患者中具有持续的高血清水平或次级峰。最后，NF-L（n = 2）仅在少数可用研究中增加，表明血清可用性>10天。到目前为止，S100 B和NSE的自动化检测可使其更快，更实用。血清中脑特异性蛋白质的连续采样揭示了不同的时间轨迹，这应该得到承认。在监测TBI患者时，血清可用性较短的蛋白质（如S100 B）在检测继发性有害事件方面可能上级NF-L等蛋白质。
The proteins S100B, neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and neurofilament light (NF-L) have been serially sampled in serum of patients suffering from traumatic brain injury (TBI) in order to assess injury severity and tissue fate. We review the current literature of serum level dynamics of these proteins following TBI and used the term “effective half-life” (t1/2) in order to describe the “fall” rate in serum. Through searches on EMBASE, Medline, and Scopus, we looked for articles where these proteins had been serially sampled in serum in human TBI. We excluded animal studies, studies with only one presented sample and studies without neuroradiological examinations. Following screening (10,389 papers), n = 122 papers were included. The proteins S100B (n = 66) and NSE (n = 27) were the two most frequent biomarkers that were serially sampled. For S100B in severe TBI, a majority of studies indicate a t1/2 of about 24 h, even if very early sampling in these patients reveals rapid decreases (1–2 h) though possibly of non-cerebral origin. In contrast, the t1/2 for NSE is comparably longer, ranging from 48 to 72 h in severe TBI cases. The protein GFAP (n = 18) appears to have t1/2 of about 24–48 h in severe TBI. The protein UCH-L1 (n = 9) presents a t1/2 around 7 h in mild TBI and about 10 h in severe. Frequent sampling of these proteins revealed different trajectories with persisting high serum levels, or secondary peaks, in patients with unfavorable outcome or in patients developing secondary detrimental events. Finally, NF-L (n = 2) only increased in the few studies available, suggesting a serum availability of >10 days. To date, automated assays are available for S100B and NSE making them faster and more practical to use. Serial sampling of brain-specific proteins in serum reveals different temporal trajectories that should be acknowledged. Proteins with shorter serum availability, like S100B, may be superior to proteins such as NF-L in detection of secondary harmful events when monitoring patients with TBI.