@article{ref1,
title="Acute biomarkers of traumatic brain injury: Relationship between plasma levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP)",
journal="Journal of neurotrauma",
year="2014",
author="Diaz-Arrastia, Ramon and Wang, Kevin K. W. and Papa, Linda and Sorani, Marco D. and Yue, John K. and Puccio, Ava M. and McMahon, Paul J. and Inoue, Tomoo and Yuh, Esther Lim and Lingsma, Hester and Maas, Andrew and Valadka, Alex and Okonkwo, David O. and Manley, Geoffrey T. and Casey, Scott S. and Cheong, Maxwell and Cooper, Shelly R. and Dams-O'connor, Kristen and Gordon, Wayne and Hricik, Allison J. and Menon, David and Mukherjee, Pratik and Schnyer, David M. and Sinha, Tuhin K. and Vassar, Mary J.",
volume="31",
number="1",
pages="19-25",
abstract="Biomarkers are important for accurate diagnosis of complex disorders such as traumatic brain injury (TBI). For a complex and multifaceted condition such as TBI, it is likely that a single biomarker will not reflect the full spectrum of the response of brain tissue to injury. Ubiquitin C-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) are among of the most widely studied biomarkers for TBI. Since UCH-L1 and GFAP measure distinct molecular events, we hypothesized that analysis of both biomarkers would be superior to each alone for diagnosis and prognosis of TBI. Serum levels of UCH-L1 and GFAP were measured in a cohort of 206 patients with TBI enrolled in a multicenter observational study (TRACK-TBI). Levels of the two biomarkers were weakly correlated to each other (r = 0.364). Each biomarker in isolation had good sensitivity and sensitivity for discriminating between TBI patients and healthy controls (AUC 0.87 and 0.91 for UCH-L1 and GFAP, respectively). When combined, superior sensitivity and specificity for diagnosing TBI was obtained (AUC 0.94). Both biomarkers discriminated between TBI patients with intracranial lesions on CT scan from those without such lesions, but GFAP measures were significantly more sensitive and specific (AUC 0.88 vs. 0.71 for UCH-L1). For association with outcome 3 months after injury, neither biomarker had adequate sensitivity and specificity (AUC 0.65 - 0.74, for GFAP, and 0.59 - 0.80 for UCH-L1, depending on GOSE threshold used). Our results support a role for multiple biomarker measurements in TBI research.<p /> <p>Language: en</p>",
language="en",
issn="0897-7151",
doi="10.1089/neu.2013.3040",
url="http://dx.doi.org/10.1089/neu.2013.3040"
}