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Clinical applications of biomarkers in pediatric traumatic brain injury
Simon J I Sandler1, Anthony A Figaji, P David Adelson
1Division of Neurosurgery, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, South Africa.
Insights
Finding reliable biomarkers for pediatric traumatic brain injury (TBI) is crucial. This review discusses S100B, NSE, MBP, and GFAP, evaluating their potential and limitations for diagnosing and predicting TBI outcomes.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Pediatric Traumatology
Background:
- Pediatric traumatic brain injury (TBI) diagnosis and outcome prediction remain challenging.
- Current clinical and radiological tools lack sensitivity and specificity for TBI assessment.
- Uncertainty exists regarding imaging needs in mild TBI and long-term sequelae, and in predicting secondary insults and outcomes in severe TBI.
Purpose of the Study:
- To review factors crucial for identifying reliable brain injury biomarkers.
- To examine existing research on common structural brain injury biomarkers.
- To discuss the utility and constraints of specific biomarkers in TBI.
Main Methods:
- Literature review of studies investigating brain injury biomarkers.
- Focus on S100B, neuron-specific enolase (NSE), myelin basic protein (MBP), and glial fibrillary acid protein (GFAP).
- Analysis of biomarker potential in the context of pediatric TBI.
Main Results:
- Several biomarkers like S100B, NSE, MBP, and GFAP have been investigated for TBI.
- These biomarkers show potential but have limitations in sensitivity and specificity.
- No single ideal biomarker for brain injury has been identified.
Conclusions:
- Biomarkers hold promise for improving TBI diagnosis, treatment, and outcome prediction.
- Further research is needed to overcome limitations of current biomarkers.
- Understanding the potential uses and limitations is key for clinical application in TBI.
Introduction:
The diagnosis, treatment, and prediction of outcome in pediatric traumatic brain injury (TBI) present significant challenges to the treating clinician. Clinical and radiological tools for assessing injury severity and predicting outcome, in particular, lack sensitivity and specificity. In patients with mild TBI, often there is uncertainty about which patients should undergo radiological imaging and who is at risk for long term neurological sequelae. In severe TBI, often there is uncertainty about which patients will experience secondary insults and what the outcome for individual patients will be. In several other clinical specialties, biomarkers are used to diagnose disease, direct treatment, and prognosticate. However, an ideal biomarker for brain injury has not been found.
Methods:
In this review, we examine the various factors that must be taken into account in the search for a reliable biomarker in brain injury. We review the important studies that have investigated common biomarkers of structural brain injury, in particular S100B, neuron-specific enolase, myelin basic protein, and glial fibrillary acid protein.
Discussion:
The potential uses and limitations of these biomarkers in the context of TBI are discussed.
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