AUTHOR=Lagerstedt Linnéa , Azurmendi Leire , Tenovuo Olli , Katila Ari J. , Takala Riikka S. K. , Blennow Kaj , Newcombe Virginia F. J. , Maanpää Henna-Riikka , Tallus Jussi , Hossain Iftakher , Gils Mark van , Menon David K. , Hutchinson Peter J. , Zetterberg Henrik , Posti Jussi P. , Sanchez Jean-Charles 

TITLE=Interleukin 10 and Heart Fatty Acid-Binding Protein as Early Outcome Predictors in Patients With Traumatic Brain Injury

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00376

DOI=10.3389/fneur.2020.00376

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Patients with traumatic brain injury (TBI) exhibit a variable and unpredictable outcome. The proteins interleukin 10 (IL-10) and heart fatty acid-binding protein (H-FABP) have shown predictive values for the presence of intracranial lesions.</p><p><bold>Aim:</bold> To evaluate the individual and combined outcome prediction ability of IL-10 and H-FABP, and to compare them to the more studied proteins S100β, glial fibrillary acidic protein (GFAP), and neurofilament light (NF-L), both with and without clinical predictors.</p><p><bold>Methods:</bold> Blood samples from patients with acute TBI (all severities) were collected &lt;24 h post trauma. The outcome was measured &gt;6 months post injury using the Glasgow Outcome Scale Extended (GOSE) score, dichotomizing patients into: (i) those with favorable (GOSE≥5)/unfavorable outcome (GOSE ≤ 4) and complete (GOSE = 8)/incomplete (GOSE ≤ 7) recovery, and (ii) patients with mild TBI (mTBI) and patients with TBIs of all severities.</p><p><bold>Results:</bold> When sensitivity was set at 95–100%, the proteins' individual specificities remained low. H-FABP showed the best specificity (%) and sensitivity (100%) in predicting complete recovery in patients with mTBI. IL-10 had the best specificity (50%) and sensitivity (96%) in identifying patients with favorable outcome in patients with TBIs of all severities. When individual proteins were combined with clinical parameters, a model including H-FABP, NF-L, and ISS yielded a specificity of 56% and a sensitivity of 96% in predicting complete recovery in patients with mTBI. In predicting favorable outcome, a model consisting IL-10, age, and TBI severity reached a specificity of 80% and a sensitivity of 96% in patients with TBIs of all severities.</p><p><bold>Conclusion:</bold> Combining novel TBI biomarkers H-FABP and IL-10 with GFAP, NF-L and S100β and clinical parameters improves outcome prediction models in TBI.</p>