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Interleukin 10 and Heart Fatty Acid-Binding Protein as Early Outcome Predictors in Patients With Traumatic Brain Injury.

Published version
Peer-reviewed

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Authors

Lagerstedt, Linnéa 
Azurmendi, Leire 
Tenovuo, Olli 
Katila, Ari J 
Takala, Riikka SK 

Abstract

Background: Patients with traumatic brain injury (TBI) exhibit a variable and unpredictable outcome. The proteins interleukin 10 (IL-10) and heart fatty acid-binding protein (H-FABP) have shown predictive values for the presence of intracranial lesions. Aim: To evaluate the individual and combined outcome prediction ability of IL-10 and H-FABP, and to compare them to the more studied proteins S100β, glial fibrillary acidic protein (GFAP), and neurofilament light (NF-L), both with and without clinical predictors. Methods: Blood samples from patients with acute TBI (all severities) were collected <24 h post trauma. The outcome was measured >6 months post injury using the Glasgow Outcome Scale Extended (GOSE) score, dichotomizing patients into: (i) those with favorable (GOSE≥5)/unfavorable outcome (GOSE ≤ 4) and complete (GOSE = 8)/incomplete (GOSE ≤ 7) recovery, and (ii) patients with mild TBI (mTBI) and patients with TBIs of all severities. Results: When sensitivity was set at 95-100%, the proteins' individual specificities remained low. H-FABP showed the best specificity (%) and sensitivity (100%) in predicting complete recovery in patients with mTBI. IL-10 had the best specificity (50%) and sensitivity (96%) in identifying patients with favorable outcome in patients with TBIs of all severities. When individual proteins were combined with clinical parameters, a model including H-FABP, NF-L, and ISS yielded a specificity of 56% and a sensitivity of 96% in predicting complete recovery in patients with mTBI. In predicting favorable outcome, a model consisting IL-10, age, and TBI severity reached a specificity of 80% and a sensitivity of 96% in patients with TBIs of all severities. Conclusion: Combining novel TBI biomarkers H-FABP and IL-10 with GFAP, NF-L and S100β and clinical parameters improves outcome prediction models in TBI.

Description

Keywords

biomarker, heart fatty-acid binding protein, interleukin 10, outcome, panel, protein, traumatic brain injury

Journal Title

Front Neurol

Conference Name

Journal ISSN

1664-2295
1664-2295

Volume Title

11

Publisher

Frontiers Media SA
Sponsorship
Academy of Medical Sciences (unknown)
European Commission (270259)
This work was partially funded by the European Commission under the 7th Framework 319 Programme (FP7-270259-TBIcare), Academy of Finland (Grant #17379) (JPP), Government’s 320 Special Financial Transfer tied to academic research in Health Sciences (Finland) (JPP), Emil 321 Aaltonen Foundation sr (JPP), Finnish Brain Foundation sr (JPP), Maire Taponen Foundation 322 (JPP), Integra EANS Research Grant (IH), Academy of Medical Sciences/The Health 323 Foundation Fellowship (VN), NIHR Research UK (through a Senior Investigator Award and 324 the Cambridge Biomedical Research Centre) (DKM); Wallenberg Academy Fellowship and 325 grants from the Swedish and European Research Councils (HZ), Torsten Söderberg 326 Professorship in Medicine, award by the Royal Swedish Academy of Sciences, grants from the 327 Swedish Research Council (KB). The authors thank our research nurses Patricia Bertenyi and 328 Satu Honkala for their valuable contribution to this study. 329 In revie