熱傷患者の血漿における中枢神経系関連バイオマーカーの測定

Burn injury produces a complex biological response across multiple organ and biological systems. Nonetheless current understanding regarding the neurologic response to burn injury is limited. Research suggests that disruption of the blood-brain barrier (BBB) may play a role in central nervous system (CNS) damage following burn trauma. As such, the purpose of this study was to investigate systemic circulating biomarkers, frequently associated with neuronal injury, to gain an understanding of their relationship to burn injury severity.

Blood from fifty-six patients admitted to the burn intensive care units was taken within 24 hours and analyzed for four CNS-related biomarkers in plasma (i.e., ubiquitin C-terminal hydrolase L1 [UCH-L1], tau protein, glial fibrillary acidic protein [GFAP], and neurofilament light [NfL]). Clinical information regarding demographics, burn severity, and health outcomes were also obtained.

We observed increased burn severity, as measured by total burn surface area (TBSA), was significantly associated with increased UCH-L1, NfL, and tau. GFAP was not associated with burn severity. In a predictive model of days spent in the hospital after injury, accuracy of the four CNS-related biomarkers was only improved by 1% when TBSA was included (i.e., 38.3% accuracy with only biomarkers vs. 39.4% accuracy with biomarkers and TBSA).

Overall, findings from this novel study highlight an association between burn injury severity and CNS-related biomarkers, thereby providing a foundation for future studies to explore both potential mechanisms associated with burn-related neurologic damage and associated functional impairments.