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Review
. 2018 Nov 8:14:2989-3000.
doi: 10.2147/NDT.S125620. eCollection 2018.

Biomarkers in traumatic brain injury (TBI): a review

Aaron Dadas  1 , Jolewis Washington  1 , Ramon Diaz-Arrastia  2 , Damir Janigro  1   3
Affiliations
Review

Biomarkers in traumatic brain injury (TBI): a review

Aaron Dadas et al. Neuropsychiatr Dis Treat. .

Abstract

Biomarkers can be broadly defined as qualitative or quantitative measurements that convey information on the physiopathological state of a subject at a certain time point or disease state. Biomarkers can indicate health, pathology, or response to treatment, including unwanted side effects. When used as outcomes in clinical trials, biomarkers act as surrogates or substitutes for clinically meaningful endpoints. Biomarkers of disease can be diagnostic (the identification of the nature and cause of a condition) or prognostic (predicting the likelihood of a person's survival or outcome of a disease). In addition, genetic biomarkers can be used to quantify the risk of developing a certain disease. In the specific case of traumatic brain injury, surrogate blood biomarkers of imaging can improve the standard of care and reduce the costs of diagnosis. In addition, a prognostic role for biomarkers has been suggested in the case of post-traumatic epilepsy. Given the extensive literature on clinical biomarkers, we will focus herein on biomarkers which are present in peripheral body fluids such as saliva and blood. In particular, blood biomarkers, such as glial fibrillary acidic protein and salivary/blood S100B, will be discussed together with the use of nucleic acids (eg, DNA) collected from peripheral cells.

Keywords: blood-brain barrier; fluid biomarkers; mild traumatic brain injury; neuroimaging; peripheral markers; post-traumatic epilepsy.

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Conflict of interest statement

Disclosure DJ and AD are employed by FloTBI, a company dealing with biomarker discovery. DJ and AD held an equity position in FloTBI. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Kinetic behavior of blood biomarkers is predicted in part by their molecular weight and rate of glomerular filtration. Notes: (A) Biomarkers levels in serum. (B) Time course of biomarker levels after BBBD, measured in serum. (C) Urine levels of biomarkers due to glomelural filtration. Note that the marker with higher m.w., GFAP, is retained in blood longer (B) and appears in urine (C) with a delay. Abbreviation: GFAP, glial fibrillary acidic protein.
Figure 2
Figure 2
Behavior of brain biomarkers under conditions of intact (A) or disrupted (B) BBB. See text for details. Abbreviation: BBB, blood–brain barrier.
Figure 3
Figure 3
Summary of blood biomarkers used in TBI. Abbreviations: EEG, electroencephalogram; GFAP, glial fibrillary acidic protein; PTE, post-traumatic epilepsy; TBI, traumatic brain injury.
See this image and copyright information in PMC

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