High-Sensitivity C-Reactive Protein is a Prognostic Biomarker of Six-Month Disability after Traumatic Brain Injury: Results from the TRACK-TBI Study.

Autor: Xu LB; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Yue JK; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Korley F; Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA., Puccio AM; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Yuh EL; Department of Radiology, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Sun X; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA., Rabinowitz M; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Vassar MJ; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Taylor SR; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Winkler EA; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Puffer RC; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.; Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA., Deng H; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., McCrea M; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Stein MB; Department of Psychiatry and Family Medicine, University of California San Diego, San Diego, California, USA., Robertson CS; Department of Neurosurgery and Critical Care, Baylor College of Medicine, Houston, Texas, USA., Levin HS; Department of Neurosurgery and Neurology, Baylor College of Medicine, Houston, Texas, USA., Dikmen S; Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA., Temkin NR; Department of Neurosurgery and Biostatistics, University of Washington, Seattle, Washington, USA., Giacino JT; Department of Rehabilitation Medicine, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA., Mukherjee P; Department of Radiology, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Wang KKW; Department of Psychiatry and Neurosciences, McKnight Brain Institute, University of Florida, Gainesville, Florida, USA., Okonkwo DO; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Markowitz AJ; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Jain S; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA., Manley GT; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA.; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Diaz-Arrastia R; Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of neurotrauma [J Neurotrauma] 2021 Apr 01; Vol. 38 (7), pp. 918-927. Date of Electronic Publication: 2020 Dec 28.
DOI: 10.1089/neu.2020.7177
Abstrakt: Systemic inflammation impacts outcome after traumatic brain injury (TBI), but most TBI biomarker studies have focused on brain-specific proteins. C-reactive protein (CRP) is a widely used biomarker of inflammation with potential as a prognostic biomarker after TBI. The T ransforming R esearch and C linical K nowledge in T raumatic B rain I njury (TRACK-TBI) study prospectively enrolled TBI patients within 24 h of injury, as well as orthopedic injury and uninjured controls; biospecimens were collected at enrollment. A subset of hospitalized participants had blood collected on day 3, day 5, and 2 weeks. High-sensitivity CRP (hsCRP) and glial fibrillary acidic protein (GFAP) were measured. Receiver operating characteristic analysis was used to evaluate the prognostic ability of hsCRP for 6-month outcome, using the Glasgow Outcome Scale-Extended (GOSE). We included 1206 TBI subjects, 122 orthopedic trauma controls (OTCs), and 209 healthy controls (HCs). Longitudinal biomarker sampling was performed in 254 hospitalized TBI subjects and 19 OTCs. hsCRP rose between days 1 and 5 for TBI and OTC subjects, and fell by 2 weeks, but remained elevated compared with HCs ( p  < 0.001). Longitudinally, hsCRP was significantly higher in the first 2 weeks for subjects with death/severe disability (GOSE <5) compared with those with moderate disability/good recovery (GOSE ≥5); AUC was highest at 2 weeks (AUC = 0.892). Combining hsCRP and GFAP at 2 weeks produced AUC = 0.939 for prediction of disability. Serum hsCRP measured within 2 weeks of TBI is a prognostic biomarker for disability 6 months later. hsCRP may have utility as a biomarker of target engagement for anti-inflammatory therapies.
Databáze: MEDLINE