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S100B vs. “GFAP and UCH-L1” assays in the management of mTBI patients

  • Charlotte Oris , Jean-Baptiste Bouillon-Minois , Samy Kahouadji ORCID logo , Bruno Pereira , Gabriel Dhaiby , Valentin Bailly Defrance , Julie Durif , Jeannot Schmidt , Farès Moustafa , Damien Bouvier and Vincent Sapin ORCID logo EMAIL logo
Published/Copyright: December 1, 2023
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 62 Issue 5

Abstract

Objectives

To compare for the first time the performance of “GFAP and UCH-L1” vs. S100B in a cohort of patients managed for mild traumatic brain injury (mTBI) according to actualized French guidelines.

Methods

A prospective study was recently carried at the Emergency Department of Clermont-Ferrand University Hospital in France. Patients with mTBI presenting a medium risk of complications were enrolled. Blood S100B and “GFAP and UCHL-1” were sampled and measured according to French guidelines. S100B was measured in patients with samples within 3 h of trauma (Cobas®, Roche Diagnostics), while GFAP and UCHL-1 were measured in all patients (samples <3 h and 3–12 h) using another automated assay (i-STAT® Alinity, Abbott).

Results

For sampling <3 h, serum S100B correctly identifies intracranial lesions with a specificity of 25.7 % (95 % CI; 19.5–32.6 %), a sensitivity of 100 % (95 % CI; 66.4–100 %), and a negative predictive value of 100 % (95 % CI; 92.5–100 %). For sampling <12 h, plasma “GFAP and UCH-L1” levels correctly identify intracranial lesions with a specificity of 31.7 % (95 % CI; 25.7–38.2 %), a sensitivity of 100 % (95 % CI; 73.5–100 %), and a negative predictive value of 100 % (95 % CI; 95–100 %). Comparison of specificities (25.7 vs. 31.7 %) did not reveal a statistically significant difference (p=0.16).

Conclusions

We highlight the usefulness of measuring plasma “GFAP and UCH-L1” levels to target mTBI patients (sampling within 12 h post-injury) and optimize the reduction of CT scans.

Keywords: GFAP; UCH-L1; S100B; automated assay; trauma
Corresponding author: Pr. Vincent Sapin, Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, 58 Rue Montalembert, 63000, Clermont-Ferrand, France; and Université Clermont Auvergne, CNRS, INSERM, GReD, Clermont-Ferrand, France, Phone: +33 4 73 75 18 01, Fax: +33 4 73 75 18 55, E-mail:

  1. Research ethics: This research complied with the tenets of the Helsinki Declaration, and has received approval by the French Patient Protection Committee (CPP Ile-de-France X) (Reference 52-2019).

  2. Informed consent: Patients were informed of their right to express their disagreement regarding the use of their clinical information for research purposes.

  3. Author contributions: CO and VS analyzed and interpreted the data. CO wrote the initial version of the manuscript. SK helped to proofread the manuscript. VS and DB designed the study and assisted with interpretation of the data and writing of the manuscript. JBBM, FM and JS supervised the trial and data collection. GD, JD and VBD carried out assays. BP provided statistical advice for the study design and analyzed the data. All the authors contributed to revision of the manuscript before submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Disclosure: The development work on the TBI in vitro diagnostic assay for use in i-STAT handheld analyzers was supported by the US Army Medical Research and Materiel Command under contract n0W81XWH-17-C-0079. The views, opinions and findings contained in this report are those of the authors and should not be constructed as an official Department of the Army position, policy or decision unless so designated by other documentation.

  7. Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-11-01
Accepted: 2023-11-20
Published Online: 2023-12-01
Published in Print: 2024-04-25

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2023-1238
Keywords for this article
GFAP; UCH-L1; S100B; automated assay; trauma

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The International Consensus on ANA Patterns (ICAP): from conception to implementation
  4. Review
  5. Machine learning-based clinical decision support using laboratory data
  6. Mini Review
  7. Standardisation and harmonisation of thyroid-stimulating hormone measurements: historical, current, and future perspectives
  8. Opinion Papers
  9. Adopting the International Consensus on ANA Patterns (ICAP) classification for reporting: the experience of Italian clinical laboratories
  10. Rising adoption of artificial intelligence in scientific publishing: evaluating the role, risks, and ethical implications in paper drafting and review process
  11. Biological variation of inflammatory and iron metabolism markers in high-endurance recreational athletes; are these markers useful for athlete monitoring?
  12. General Clinical Chemistry and Laboratory Medicine
  13. A model for managing quality control for a network of clinical chemistry instruments measuring the same analyte
  14. Impact of Academia-Government Collaboration on Laboratory Medicine Standardization in South Korea: analysis of eight years creatinine proficiency testing experience
  15. Measurement uncertainty estimation of free drug concentrations in clinical laboratories using equilibrium dialysis
  16. Use of dried blood spots for monitoring inflammatory and nutritional biomarkers in the elderly
  17. S100B vs. “GFAP and UCH-L1” assays in the management of mTBI patients
  18. Evaluation of five multisteroid LC‒MS/MS methods used for routine clinical analysis: comparable performance was obtained for nine analytes
  19. Ensuring quality in 17OHP mass spectrometry measurement: an international study assessing isomeric steroid interference
  20. A novel LC-MS/MS-based assay for the simultaneous quantification of aldosterone-related steroids in human urine
  21. Clinical specificity of two assays for immunoglobulin kappa and lambda free light chains
  22. Reference Values and Biological Variations
  23. Estimation of the reference values and decision limits for growth hormone in newborns using dried blood spots
  24. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population
  25. Hematology and Coagulation
  26. Detection of blasts using flags and cell population data rules on Beckman Coulter DxH 900 hematology analyzer in patients with hematologic diseases
  27. Cancer Diagnostics
  28. Drainage fluid LDH and neutrophil to lymphocyte ratio as biomarkers for early detecting anastomotic leakage in patients undergoing colorectal surgery
  29. Cardiovascular Diseases
  30. Performance evaluation of a novel high-sensitivity cardiac troponin T assay: analytical and clinical perspectives
  31. Diabetes
  32. Ferric particle-assisted LDI-MS platform for metabolic fingerprinting of diabetic retinopathy
  33. Infectious Diseases
  34. Thrombopoietin levels in sepsis and septic shock – a systematic review and meta-analysis
  35. Effect of temperature on presepsin pre-analytical stability in biological fluids of preterm and term newborns
  36. Letters to the Editor
  37. Pseudohyperglycemia due to glucometer interference in galactosemia
  38. What could cause a false increase in serum C-reactive protein concentration?
  39. Discriminating signal from noise: the biological variation of circulating calprotectin in serum and plasma
  40. Diagnostic accuracy of adenosine deaminase for tuberculous pleural effusion: age does matter
  41. The role of the Brazilian proficiency testing/External Quality Assessment Program in the improvement of glycated hemoglobin measurement
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