Extracellular Vesicle Levels of Nervous System Injury Biomarkers in Critically Ill Trauma Patients with and without Traumatic Brain Injury.
| Autor: | Guedes VA; National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA., Mithani S; School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA., Williams C; Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA., Sass D; National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA., Smith EG; National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA., Vorn R; National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA., Wagner C; School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA., Lai C; National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA., Gill J; School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA., Hinson HE; Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Neurotrauma reports [Neurotrauma Rep] 2022 Dec 19; Vol. 3 (1), pp. 545-553. Date of Electronic Publication: 2022 Dec 19 (Print Publication: 2022). |
| DOI: | 10.1089/neur.2022.0058 |
| Abstrakt: | Moderate/severe traumatic brain injury (TBI) causes injury patterns with heterogeneous pathology producing varying outcomes for recovery. Extracellular vesicles (EVs) are particles containing a myriad of molecules involved in cell signaling. EVs may hold promise as biomarkers in TBI because of their encapsulation, including improved stability/decreased degradation. A subset of subjects with and without TBI from a prospective, observational trial of critically ill trauma patients were analyzed. Total EV levels of glial (glial fibrillary acidic protein; GFAP) and neuronal/axonal (ubiquitin carboxy-terminal hydrolase L1 [UCH-L1], neurofilament light chain [NfL], and total-tau) proteins were measured using single-molecule array technology. Protein levels were winsorized to address outliers and log transformed for analysis. Patients with multiple injuries ( n = 41) and isolated body injury ( n = 73) were of similar age and sex. Patients with multiple injuries were, as expected, more severely injured with higher Injury Severity Scores (29 [26-41] vs. 21 [14-26], p < 0.001) and lower Glasgow Coma Scale scores (12 [4-13] vs. 13 [13-13], p < 0.001). Total body EVs of GFAP, UCH-L1, and NfL were higher in those with multiple injuries (1768 [932-4780] vs. 239 [63-589], p < 0.001; 75.4 [47.8-158.3] vs. 41.5 [21.5-67.1], p = 0.03; 7.5 [3.3-12.3] vs. 2.9 [2.1-4.8], p < 0.001, respectively). There was a moderate correlation between the Head Abbreviated Injury Score and GFAP (free circulating rho = 0.62, EV rho = 0.64; both p < 0.001). Brain-derived proteins contained in EV holds promise as an informative approach to biomarker measurement after TBI in hospitalized patients. Future evaluation and longitudinal studies are necessary to draw conclusions regarding the clinical utility of these biomarkers. Competing Interests: No competing financial interests exist. (© Vivian A. Guedes et al., 2022; Published by Mary Ann Liebert, Inc.) |
| Databáze: | MEDLINE |
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