Brain-related proteins as serum biomarkers of acute, subconcussive blast overpressure exposure: A cohort study of military personnel
Brain-related proteins as serum biomarkers of acute, subconcussive blast overpressure exposure: A cohort study of military personnel
复制标题
DOI：
10.1371/journal.pone.0221036
复制
发表时间：
2019-08-13
期刊：
影响因子：
3.7
通讯作者：
Kamimori, Gary H.
中科院分区：
文献类型：
--
作者：
Boutte, Angela M.;Thangavelu, Bharani;Kamimori, Gary H.
反复暴露于爆炸超压仍然是军事人员健康不良的一个主要原因，因此，他们患神经退行性疾病和自杀的风险更高。对与爆炸有关的影响进行急性、早期跟踪有望在慢性问题发生之前进行快速健康评估。目前用于确定爆炸相关影响的技术依赖于类似于脑震荡的神经病学报告和与操作减量相关的神经认知评估。在这里，我们描述了一个横截面研究的结果，观察。作为一种定量和微创策略，测试了爆炸暴露一小时内收集的血清中多种TBI相关蛋白的浓度，以加强对与脑震荡样症状和反应时间减少相关的爆炸暴露影响的评估。我们确定了中位简单反应时间（SRT）与超压暴露后血清Nf-L、tau、A β-40和A β-42的升高一致。相反，血清GFAP的中位数水平降低。个体、受试者间分析显示Nf-L和GFAP变化之间以及A β-40与A β-42变化之间呈正相关。Nf-L的变化与tau、A beta-40和A beta-42呈负相关。参与者报告说，他们经历了头痛、头晕和思考时间延长。头晕与反应时间减少、GFAP或NfL抑制以及A β肽升高相关。UCH-L1升高与mTBI/脑震荡史相关性较弱。多重血清生物标志物定量，加上反应时间评估和爆炸暴露前后确定的神经病学，可以作为一个平台，在没有头部创伤或诊断脑震荡的情况下跟踪不良反应。我们建议进一步评估血清生物标志物，这往往是与TBI，在急性操作冲击波暴露的背景下。
Repeated exposure to blast overpressure remains a major cause of adverse health for military personnel who, as a consequence, are at a higher risk for neurodegenerative disease and suicide. Acute, early tracking of blast related effects holds the promise of rapid health assessment prior to onset of chronic problems. Current techniques used to determine blast-related effects rely upon reporting of symptomology similar to that of concussion and neurocognitive assessment relevant to operational decrement. Here, we describe the results of a cross sectional study with pared observations. The concentration of multiple TBI-related proteins was tested in serum collected within one hour of blast exposure as a quantitative and minimally invasive strategy to augment assessment of blast-exposure effects that are associated with concussion-like symptomology and reaction time decrements. We determined that median simple reaction time (SRT) was slowed in accordance with serum Nf-L, tau, A beta-40, and A beta-42 elevation after overpressure exposure. In contrast, median levels of serum GFAP decreased. Individual, inter-subject analysis revealed positive correlations between changes in Nf-L and GFAP, and in A beta-40 compared to A beta-42. The change in Nf-L was negatively associated with tau, A beta-40, and A beta-42. Participants reported experiencing headaches, dizziness and taking longer to think. Dizziness was associated with reaction time decrements, GFAP or NfL suppression, as well as A beta peptide elevation. UCH-L1 elevation had a weak association with mTBI/concussion history. Multiplexed serum biomarker quantitation, coupled with reaction time assessment and symptomology determined before and after blast exposure, may serve as a platform for tracking adverse effects in the absence of a head wound or diagnosed concussion. We propose further evaluation of serum biomarkers, which are often associated with TBI, in the context of acute operational blast exposures.