Brain Enzyme May Help to Flag Severity of Traumatic Injuries

Article excerpt

CHICAGO -- An enzyme found in brain cells may become the first bedside biomarker for assessing the severity of traumatic brain injury, according to Dr. Linda Papa.

In a multicenter trial, levels of the enzyme ubiquitin C-terminal hydrolase (UCH-L1) rose significantly in severely injured brains, an increase that paralleled the rise in cerebral spinal fluid and correlated with the Glasgow Coma Scale (GCS) score, Dr. Papa said at the annual meeting of the Society for Academic Emergency Medicine.

"We know that bio-markers can provide diagnostic and prognostic information, give us insight into the pathophysiology of the brain injury, and guide therapy in both the emergency department and intensive care unit," said Dr. Papa, director of academic clinical research at Orlando (Fla.) Regional Medical Center.

If further study confirms the value of UCH-L1 as the first clinical biomarker in traumatic brain injury (TBI), physicians will be better able to identify targets for drug therapy and guide the timing of treatment with such agents as tissue plasminogen activator, she explained.

This prospective case-control study enrolled consecutive adult patients presenting to two tertiary care teaching hospitals following severe TBIs, defined by a GCS score of less than 8 and requiring invasive intracerebral monitoring.

The primary outcome was severity of injury as measured by postresuscitation and 24-hour dichotomized GCS score. Secondary outcome included the presence of evolving lesions on CT scan at 24 and 72 hours post injury. …