Table 3.
Emerging biomarkers of TBI
| Mechanism | Biomarkers | Sample source | Detection technology | Utility* | References |
|---|---|---|---|---|---|
| Damage of neuron cell body | UCH-L1 | Serum | Sandwich ELISA | 1 | [114] |
| NSE | CSF | Electro chemiluminescent assay | [115] | ||
| Damage of astrocytes | GFAP | Serum | Sandwich ELISA | 1, 2, 3, 4 | [116] |
| S100-B | Serum; CSF | Automatic electrochemiluminescence immunoassay | 1, 2, 4 | [117, 118] | |
| Death of neuron | SBDPs | CSF | Bicinchoninic acid microprotein assays | 1 | [119] |
| Damage of axon | NF proteins | CSF | ELISA and size-exclusion chromatography and mass spectrometry | 1, 2, 4 | [120] |
| Damage of white matter | MBP | Serum; CSF | ELISA | 1, 2 | [121] |
| Post-injury neurodegeneration and autoimmune response | Total Tau and phospho-Tau | Brain tissue | Immunohistochemical analysis | 1, 2, 4 | [122] |
| Brain antigen-targeting autoantibodies | Serum | ELISA | 3, 4 | [123] | |
| Chronic neuronal dendrite regeneration | MAP-2 | Serum | ELISA | 4 | [124] |
| Survival and regeneration of neurons and axons | BNDF | Serum | Electro chemiluminescent sandwich immunoassay | 4 | [125] |
| NRGN | [126] | ||||
| VEGF, etc. | Automatic clotting instrument, etc | [124] | |||
| Damage of brain | miRNA | Serum | TaqMan microRNA assays and RT-PCR | 1, 5 | [127] |
| HIF-1α | Immunofluorescence staining | [118] | |||
| Caspase 3 and C5b-9 | [118] | ||||
| Damage of neuron** | CNA | Serum | PCR | 1, 2 | [128] |
| Exosome and microvesicles | Serum; CSF | Precipitation reagent and nano sight imaging technology | [129] |
In the above studies, the subjects were not limited to military personnel, so the possibility of negative results in the population of military TBI patients cannot be ruled out
UCH-L1 Ubiquitin carboxy-terminal hydrolase L1, NSE Neuron specific enolase, GFAP Glial fibrillary acidic protein S100-B Central nervous system specific protein-B, SBDPs αII-spectrin breakdown products, NF Proteins Neurofilament proteins, MBP Myelin basic protein, MAP-2 Microtubule-associated protein-2, BNDF Brain derived nerve growth factor, NRGN Postsynaptic protein neurogranin, CNA Circulating nucleic acids, PCR Polymerase chain reaction, RT-PCR Reverse transcription-polymerase chain reaction, VEGF Vascular endothelial growth factor, HIF-1α Hypoxia-inducible factor-1 alpha, C5b-9 Terminal complement complex, CSF Cerebrospinal fluid, ELISA Enzyme-linked immunosorbent assay, Ref References
*The utility here refers only to potential utility, and its accuracy is questionable because most biomarker studies are only experimental and have not been applied in clinical settings. Diagnosis = 1; Prediction = 2; Clinical Classification = 3; Chronic Monitoring = 4; Death Review = 5
**Total free DNA levels in patients' plasma are an independent predictor of traumatic death in cases of severe traumatic brain injury