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Blood-Based Analysis of Different Tau Variants in Patients With Multiple Traumatic Injuries.

Rebecca Halbgebauer1, Fernando Gonzalez-Ortiz2, Benjamin Mayer3

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Blood tau levels, including brain-derived tau (BD-tau), are elevated after multiple traumatic injuries. These tau variants may indicate neurological injury severity and persist in the acute phase, particularly BD-tau.

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Area of Science:

  • Neuroscience
  • Biomarker Discovery
  • Trauma Research

Background:

  • Blood-based phosphorylated tau biomarkers are emerging for Alzheimer disease diagnosis.
  • Understanding tau release mechanisms in conditions beyond Alzheimer disease is crucial for biomarker interpretation.
  • The role of tau variants in acute traumatic injuries remains largely unexplored.

Purpose of the Study:

  • To measure phosphorylated and nonphosphorylated tau variants in the blood of multiple trauma patients.
  • To assess tau levels at multiple time points post-injury (days 0, 1, 5, and 10).
  • To investigate biological processes influencing tau release into circulation following trauma.

Main Methods:

  • A cohort of 45 severely injured patients (with or without moderate-to-severe traumatic brain injury) and 24 healthy controls were studied.
  • Serum levels of brain-derived tau (BD-tau), total tau (t-tau), and phosphorylated tau 217 (p-tau217) and 231 (p-tau231) were analyzed.
  • Associations between tau levels, injury severity, Glasgow Coma Scale (GCS) scores, hemorrhagic shock, and survival outcomes were examined.

Main Results:

  • Significantly elevated serum levels of t-tau, BD-tau, and p-tau231 were observed in multiple trauma patients compared to controls at day 0.
  • BD-tau levels remained elevated up to day 10 post-injury, indicating persistent elevation.
  • Higher tau levels correlated with lower GCS scores, presence of hemorrhagic shock, and poorer survival outcomes.

Conclusions:

  • Tau variants in the blood of trauma patients reflect both direct and indirect neurological injury.
  • Brain-derived tau (BD-tau) demonstrates the most sustained elevation during the acute phase following severe trauma.
  • These findings suggest tau variants could serve as potential biomarkers for neurological damage in trauma settings.