Serum Glial Fibrillary Acidic Protein Is a Highly Specific... : Journal of Trauma and Acute Care Surgery (original) (raw)

Original Article

Serum Glial Fibrillary Acidic Protein Is a Highly Specific Biomarker for Traumatic Brain Injury in Humans Compared With S-100B and Neuron-Specific Enolase

Honda, Masahiro MD; Tsuruta, Ryosuke MD, PhD; Kaneko, Tadashi MD; Kasaoka, Shunji MD, PhD; Yagi, Takeshi MD; Todani, Masaki MD; Fujita, Motoki MD; Izumi, Tomonori PhD; Maekawa, Tsuyoshi MD, PhD

From the Advanced Medical Emergency and Critical Care Center (M.H., R.T., T.K., S.K., T.Y., M.T., M.F., T.M.), Yamaguchi University Hospital, Japan; Department of Stress and Bio-response Medicine (T.I.), Yamaguchi University Graduate School of Medicine, Japan.

Submitted for publication March 18, 2009.

Accepted for publication August 11, 2009.

Supported by the Japanese Ministry of Health, Labor, and Welfare research project grant 19791329.

All work was conducted independently of the funding bodies. Although one grant was governmental, this grant did not influence the choice of study design or publication.

Address for reprints: Tadashi Kaneko, Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minamikogushi Ube, Yamaguchi, Japan; email: [email protected].

The Journal of Trauma: Injury, Infection, and Critical Care 69(1):p 104-109, July 2010. | DOI: 10.1097/TA.0b013e3181bbd485

Abstract

Background:

Serum glial fibrillary acidic protein (GFAP) is a specific predictor of brain damage and neurologic outcome in patients with traumatic brain injury (TBI). In this study, serum GFAP, S-100B, and neuron-specific enolase (NSE) were compared in the same samples from severe trauma patients to assess their ability to predict abnormalities detectable on head computed tomography (CT).

Methods:

This study was a retrospective analysis at a single university emergency center. Thirty-four trauma patients were included. Serum samples were collected from the patients for 3 days. Serum GFAP, S-100B, and NSE concentrations were measured with enzyme-linked immunosorbent assays and compared in patients with and without TBI, as evaluated by head CT.

Results:

Serum GFAP, S-100B, and NSE were significantly higher in the TBI patients than in the non-TBI patients (p < 0.05 for each protein). The receiver operating characteristic curves for TBI were compared for the three biomarkers for 3 days. Serum GFAP on day 1 had the largest area under the receiver operating characteristic curve (0.983), with 88.9% sensitivity and 100% specificity.

Conclusions:

Serum GFAP has remarkable diagnostic value for TBI, defined by abnormal head CT findings, in prehospital-triaged patients with severe trauma.