GFAP and S100B: What You Always Wanted to Know and Never Dared to Ask

Area of Science:

• Neuroscience
• Biomarkers
• Clinical Diagnostics

Background:

• Traumatic brain injury (TBI) presents a significant global health challenge, leading to severe outcomes and impacting individuals, families, and healthcare systems.
• Early TBI diagnosis via peripheral fluids like blood or saliva is a key research focus, with FDA-approved assays for GFAP and UCH-L1, and GFAP point-of-care tests.
• The biomarker S100B is incorporated into European clinical guidelines for mild TBI (mTBI), yet challenges remain regarding data robustness, biomarker presence beyond the central nervous system, and peripheral fluid kinetics.

Approach:

• This review analyzes existing literature to address unresolved issues in TBI biomarker research.
• It focuses on two primary astrocytic proteins, S100B and GFAP, commonly used in mild TBI (mTBI) diagnostics.
• The article provides a viewpoint and recommendations for broader clinical adoption of these tools.

Key Points:

• Despite advancements like FDA-approved GFAP/UCH-L1 assays and S100B inclusion in mTBI guidelines, critical questions persist about biomarker reliability and distribution.
• Understanding the presence of biomarkers in various tissues and their temporal dynamics in peripheral fluids is essential for accurate TBI assessment.
• Astrocytic proteins S100B and GFAP are central to current mTBI biomarker strategies.

Conclusions:

• Further research is needed to address the robustness and distribution of TBI biomarkers like S100B and GFAP.
• Recommendations are provided to enhance the clinical utility and acceptance of these peripheral fluid biomarkers for TBI diagnosis.
• Improving TBI diagnostic tools through biomarker analysis can lead to better patient outcomes and healthcare management.