Serum τ protein as a potential biomarker in the assessment of traumatic brain injury

Wang,Junwen; Li,Jun; Han,Lin; Guo,Songbo; Wang,Lei; Xiong,Zuojun; Chen,Zhi; Chen,Wen; Liang,Jian

doi:10.3892/etm.2016.3017

Serum τ protein as a potential biomarker in the assessment of traumatic brain injury

Authors:
- Junwen Wang
- Jun Li
- Lin Han
- Songbo Guo
- Lei Wang
- Zuojun Xiong
- Zhi Chen
- Wen Chen
- Jian Liang
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Affiliations: Department of Neurosurgery, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China, Department of Neurosurgery, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430014, P.R. China
Published online on: January 22, 2016 https://doi.org/10.3892/etm.2016.3017
Pages: 1147-1151

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Abstract

Traumatic brain injury (TBI) is the leading cause of mortality and disabilities among all trauma cases. Following TBI, damage to axons results in τ protein hyperphosphorylation leading to microtubule instability and τ‑mediated neurodegeneration. In addition, τ protein is proteolytically cleaved and is able to access the cerebrospinal fluid (CSF) and serum; thus, this protein may serve as a potential biomarker in the diagnosis of injury severity and outcome prediction. Although a limited number of studies have investigated the CSF τ protein levels after TBI, the data are divergent and conflicting, and investigations into the serum τ protein levels have yet to be conducted. Therefore, the present study aimed to examine the serum τ protein levels in the full spectrum of TBI patients on days 0‑14 after TBI, using an enzyme‑linked immunosorbent assay. The protein levels were compared to the initial Glasgow Coma Score (GCS) and the Extended Glasgow Outcome Scale (GOS‑E), which are used to represent the injury severity and patient outcome, respectively. In total, 56 patients, including 20 patients with mild TBI (GCS, 13‑15), 19 patients with moderate TBI (GCS, 9‑12) and 17 patients with severe TBI (GCS, 3‑8), were included in the current study. The outcome was assessed 1 year after the injury and patients were classified into the good outcome (40 cases; GOS‑E, 5‑8) and poor outcome groups (16 cases; GOS‑E, 1‑4). The results indicated that serum τ protein levels increased soon after TBI and reached a peak value at ~2 days after the injury. The serum τ protein levels were significantly higher in the severe TBI group compared with those in the mild and moderate TBI groups (P<0.0001). Univariate analysis indicated that poor outcome was significantly associated with higher serum τ protein levels on day 2 (P<0.0001). A receiver operating characteristic curve demonstrated that a τ protein level of >116.04 pg/ml on day 2 resulted in a 93.75% sensitivity and 92.50% specificity for predicting a poor outcome. Furthermore, a τ protein level of >372.1 pg/ml on day 2 yielded 100% sensitivity and 83.33% specificity for 1 year mortality in the severe TBI group. In conclusion, the present study suggests that serum τ protein may serve as a potential biomarker for evaluating the injury severity and predicting the outcome of TBI patients.

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