• Plos One · Jan 2017

    H-FABP: A new biomarker to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury.

    • Linnéa Lagerstedt, Juan José Egea-Guerrero, Alejandro Bustamante, Joan Montaner, Ana Rodríguez-Rodríguez, Amir El Rahal, Natacha Turck, Manuel Quintana, Roser García-Armengol, Carmen Melinda Prica, Elisabeth Andereggen, Lara Rinaldi, Asita Sarrafzadeh, Karl Schaller, and Jean-Charles Sanchez.
    • Department of Human Protein Sciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
    • Plos One. 2017 Jan 1; 12 (4): e0175572.

    AbstractThe majority of patients with mild traumatic brain injury (mTBI) will have normal Glasgow coma scale (GCS) of 15. Furthermore, only 5%-8% of them will be CT-positive for an mTBI. Having a useful biomarker would help clinicians evaluate a patient's risk of developing intracranial lesions. The S100B protein is currently the most studied and promising biomarker for this purpose. Heart fatty-acid binding protein (H-FABP) has been highlighted in brain injury models and investigated as a biomarker for stroke and severe TBI, for example. Here, we evaluate the performances of S100B and H-FABP for differentiating between CT-positive and CT-negative patients. A total of 261 patients with a GCS score of 15 and at least one clinical symptom of mTBI were recruited at three different European sites. Blood samples from 172 of them were collected ≤ 6 h after trauma. Patients underwent a CT scan and were dichotomised into CT-positive and CT-negative groups for statistical analyses. H-FABP and S100B levels were measured using commercial kits, and their capacities to detect all CT-positive scans were evaluated, with sensitivity set to 100%. For patients recruited ≤ 6 h after trauma, the CT-positive group demonstrated significantly higher levels of both H-FABP (p = 0.004) and S100B (p = 0.003) than the CT-negative group. At 100% sensitivity, specificity reached 6% (95% CI 2.8-10.7) for S100B and 29% (95% CI 21.4-37.1) for H-FABP. Similar results were obtained when including all the patients recruited, i.e. hospital arrival within 24 h of trauma onset. H-FABP out-performed S100B and thus seems to be an interesting protein for detecting all CT-positive mTBI patients with a GCS score of 15 and at least one clinical symptom.

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