New Combo of Biomarkers Can Distinguish Concussions From Other Injuries
Several past studies have found numerous potential blood biomarkers which could help identify and diagnose traumatic brain injury, and now a new report suggests a panel of a select number of these biomarkers is capable of identifying brain injury within hours.
Most importantly, the new method uses lab arrays widely available in most health centers.
Most previous studies focused on detecting proteins released from dying brain injury, but these proteins are not reliable or often require specific and not-widely available antibodies to properly measure, according to Adam Chodobski, associate professor of emergency medicine in the Alpert Medical School of Brown University.
“Our approach was very different,” says Chodobski, also a Lifespan researcher who directs the Neurotrauma and Brain Barriers Research Laboratory. “We wanted to look at proteins that are produced in response to injury and then appear in the circulation.”
The report, published in the Journal of Neurotrauma, identified four proteins (copeptin, galectin 3, matrix metalloproteinase 9, and occludin) that changed significantly in the bloodstream of patients in the time shortly after brain injury.
Ultimately, the correlation of two such proteins were especially effective as they helped distinguish patients who had brain injuries from those who suffered orthopedic injuries such as bone fractures.
For the study, the researchers recruited three groups of participants: one experimental group and two control groups. The experimental group included 55 emergency room patients diagnosed with concussions via traditional methods. One control group comprised 44 uninjured people, while the last control group included 17 patients with long-bone fractures.
The researchers evaluated 18 proinflammatory proteins in all participants.
Out of those 18 proteins, the researchers found four which could be used as potential biomarkers – galectin 3, matrix metalloproteinase 9, occluding, and copeptin. Copeptin was especially affected by brain injuries, dipping to nearly three-times lower concentration compared to the healthy participants.
The last step for the researchers was to distinguish how these biomarkers were impacted by brain injuries from cases of other injuries.
Uninjured individuals commonly showed heightened levels of one of the four proteins identified by the study, but none showed high levels of more than one at a time. Meanwhile, 90 percent of concussion patients had markedly altered concentrations of two or more simultaneously.
The researchers also noticed each of these proteins are significantly altered in participants with bone breaks, the findings showed that only in the concussed patients did elevated occluding correlate with elevated galectin 3. That means the four proteins considered together are capable of identifying concussions in people with potential other injuries elsewhere on the body.