11 - The Potential of S100B and GFAP as Molecular Biomarkers for Predicting Severity and Progression of Traumatic Brain Injury

Poster Board Number: 11
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Odd poster #s – first hour
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Co-authors:

Rohen Harrichandparsad - Senior Doctor, Department of Neurosurgery,, Inkosi Albert Luthuli Central Hospital; Lelika Lazarus - Professor, Clinical Anatomy, University of KwaZulu-Natal; Thajasvarie Naicker - Professor, Discipline of Optics & Imaging, Doris Duke Medical Research Institute, University of KwaZulu-Natal

Abstract Body : Background: Traumatic brain injury (TBI) occurs as a result of a severe head injury caused by an external force during a vehicle accident, fall, domestic violence, or explosion. The existing data shows that approximately 69 million individuals per year are projected to sustain TBI worldwide. In sub-Saharan Africa, the prevalence of TBI is 150–170 per 100 000 individuals. It is estimated that by the year 2050, the TBI prevalence in Africa will increase to 14.25±0.75 million due to increased urbanization. TBI is evaluated and classified clinically according to the Glasgow Coma Scale (GCS), associated with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). However, there are many limitations associated with GCS. Therefore, the aim of this study was to investigate the role of serum S100 calcium-binding protein B (S100B) and Glial Fibrillary Acidic Protein (GFAP) as potential biomarkers for detection and diagnosis for human TBI.

This pilot study utilized purposive sampling of serum fluid of 78 adult patients with moderate to severe TBI. The S100B and GFAP concentrations were determined by multiplex immunoassay technique (ELISA) following the manufacturer's instructions. The data generated were subjected to statistical analysis using a one-way analysis of variance and Dunn's multiple comparisons post hoc tests using Graph pad prism software version 9.00. The results obtained were expressed as mean ± standard error of the mean at P< 0.05.

There were no significance differences (P < 0.2162) between the serum concentrations of S100B protein in the moderate TBI compared with control. However, a significant increase in the serum concentration of S100B protein was observed in the severe TBI compared with the control (P< 0.0002) and moderate (P< 0.0011) TBI. The serum concentrations of GFAP proteins were significantly increased in the moderate (p< 0.0015) and severe (p< 0.0083) categories of TBI as opposed to the control. However, there was no significance difference (p< 0.9999) between the serum concentrations of moderate and severe TBI categories.

This finding confirms that the significant increased concentration of S100B and GFAP proteins increase the severity and worsen the progression of TBI. Hence, S100B and GFAP can be utilized as biomarkers for better prediction of severity and progression of TBI from moderate to severe categories, combination of these two biomarkers and the current GCS system may provide better diagnostic results.