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Table 3 Emerging biomarkers of TBI

From: Military traumatic brain injury: a challenge straddling neurology and psychiatry

Mechanism Biomarkers Sample source Detection technology Utility* References
Damage of neuron cell body UCH-L1 Serum Sandwich ELISA 1 [114]
  NSE CSF Electro chemiluminescent assay   [115]
Damage of astrocytes GFAP Serum Sandwich ELISA 1, 2, 3, 4 [116]
  S100-B Serum; CSF Automatic electrochemiluminescence immunoassay 1, 2, 4 [117, 118]
Death of neuron SBDPs CSF Bicinchoninic acid microprotein assays 1 [119]
Damage of axon NF proteins CSF ELISA and size-exclusion chromatography and mass spectrometry 1, 2, 4 [120]
Damage of white matter MBP Serum; CSF ELISA 1, 2 [121]
Post-injury neurodegeneration and autoimmune response Total Tau and phospho-Tau Brain tissue Immunohistochemical analysis 1, 2, 4 [122]
  Brain antigen-targeting autoantibodies Serum ELISA 3, 4 [123]
Chronic neuronal dendrite regeneration MAP-2 Serum ELISA 4 [124]
Survival and regeneration of neurons and axons BNDF Serum Electro chemiluminescent sandwich immunoassay 4 [125]
  NRGN     [126]
  VEGF, etc.   Automatic clotting instrument, etc   [124]
Damage of brain miRNA Serum TaqMan microRNA assays and RT-PCR 1, 5 [127]
  HIF-1α   Immunofluorescence staining   [118]
  Caspase 3 and C5b-9     [118]
Damage of neuron** CNA Serum PCR 1, 2 [128]
  Exosome and microvesicles Serum; CSF Precipitation reagent and nano sight imaging technology   [129]
  1. In the above studies, the subjects were not limited to military personnel, so the possibility of negative results in the population of military TBI patients cannot be ruled out
  2. UCH-L1 Ubiquitin carboxy-terminal hydrolase L1, NSE Neuron specific enolase, GFAP Glial fibrillary acidic protein S100-B Central nervous system specific protein-B, SBDPs αII-spectrin breakdown products, NF Proteins Neurofilament proteins, MBP Myelin basic protein, MAP-2 Microtubule-associated protein-2, BNDF Brain derived nerve growth factor, NRGN Postsynaptic protein neurogranin, CNA Circulating nucleic acids, PCR Polymerase chain reaction, RT-PCR Reverse transcription-polymerase chain reaction, VEGF Vascular endothelial growth factor, HIF-1α Hypoxia-inducible factor-1 alpha, C5b-9 Terminal complement complex, CSF Cerebrospinal fluid, ELISA Enzyme-linked immunosorbent assay, Ref References
  3. *The utility here refers only to potential utility, and its accuracy is questionable because most biomarker studies are only experimental and have not been applied in clinical settings. Diagnosis = 1; Prediction = 2; Clinical Classification = 3; Chronic Monitoring = 4; Death Review = 5
  4. **Total free DNA levels in patients' plasma are an independent predictor of traumatic death in cases of severe traumatic brain injury