Glial fibrillary acidic protein as a biomarker for brain injury in neonatal CHD

AbstractNeonates with critical CHD have evidence, by imaging, of preoperative brain injury, although the timing is unknown. We used circulating postnatal serum glial fibrillary acidic protein as a measure of acute perinatal brain injury in neonates with CHD. Glial fibrillary acidic protein was measured on admission and daily for the first 4 days of life in case and control groups; we included two control groups in this study – non-brain-injured newborns and brain-injured newborns. Comparisons were performed using the Kruskal–Wallis test with Dunn’s multiple comparisons, Student’s t-test, and χ2 test of independence where appropriate. In aggregate, there were no significant differences in overall glial fibrillary acidic protein levels between CHD patients (n=56) and negative controls (n=23) at any time point. By day 4 of life, 7/56 (12.5%) CHD versus 0/23 (0%) normal controls had detectable glial fibrillary acidic protein levels. Although not statistically significant, the 5/10 (50%) left heart obstruction group versus 1/17 (6%) conoventricular, 0/13 (0%) right heart, and 1/6 (17%) septal defect patients trended towards elevated levels of glial fibrillary acidic protein at day 4 of life. Overall, glial fibrillary acidic protein reflected no evidence for significant peripartum brain injury in neonates with CHD, but there was a trend for elevation by postnatal day 4 in neonates with left heart obstruction. This pilot study suggests that methods such as monitoring glial fibrillary acidic protein levels may provide new tools to optimise preoperative care and neuroprotection in high-risk neonates with specific types of CHD.

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SERUM GLIAL FIBRILLARY ACIDIC PROTEIN LEVELS PROFILE IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v24i1.1151 ◽

2018 ◽

Vol 24 (1) ◽

pp. 24

Author(s):

Arief S. Hariyanto ◽

Endang Retnowati ◽

Agus Turchan

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Severe Traumatic Brain Injury ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Specific Protein ◽

Acidic Protein ◽

Protein Levels

Glial Fibrillary Acidic Protein (GFAP) sangat khas untuk otak (highly brain specific protein), sebagai petunjuk kerusakan sel,merupakan protein yang berhubungan dengan peningkatan tekanan intrakranial dan sebagai petanda perjalanan penyakit di pasiencedera otak. Penelitian ini menganalisis profil kadar GFAP serum pasien cedera otak berat sebagai petanda perjalanan penyakit dankeluarannya. Desain penelitian deskriptif observasional. Kadar GFAP serum dari sampel darah vena, diperiksa dengan metode ELISApada hari pertama datang ke Instalasi Gawat Darurat dan hari ke-2,3,4 perawatan. Jumlah sampel 25 orang, laki-laki 20 orang (80%),perempuan 5 orang (20%). Umur terbanyak ≤ 25 tahun, 8 orang (32%), rerata umur 35,92 ± 13,80 tahun. Jejas berdasarkan hasilCT Scan kepala terbanyak Diffuse Axonal Injury (DAI) 7 (28%), tindakan operasi sebanyak 18 (72 %), non-operasi 7 (28%), penyebabcedera, kecelakaan lalu lintas 23 (92%), jatuh 2 (8%). Rerata kadar GFAP serum hari ke-1,2,3,4 berturut-turut 2,72±1,44 ng/mL,1,85±0,85 ng/mL, 1,67±1,26 ng/mL, 0,79±0,35 ng/mL. Keluaran pasien, hidup 19 (76%), meninggal 6 (24%). GFAP sangat khaspada otak berguna sebagai petanda di pasien cedera otak berat, yaitu peningkatan kadarnya dapat digunakan sebagai faktor perjalananpenyakit untuk kematian dan keluarannya. Peningkatan kadar GFAP serum dapat digunakan sebagai faktor perjalanan penyakit.Penelitian lanjutan diperlukan dengan sampel yang lebih besar

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Neuron-Specific Enolase, S100B, and Glial Fibrillary Acidic Protein Levels as Outcome Predictors in Patients With Severe Traumatic Brain Injury

Neurosurgery ◽

10.1227/neu.0b013e318214a81f ◽

2011 ◽

Vol 68 (6) ◽

pp. 1624-1631 ◽

Cited By ~ 101

Author(s):

Ana Elisa Böhmer ◽

Jean Pierre Oses ◽

André Prato Schmidt ◽

Cleiton Schweister Perón ◽

Claudio Liss Krebs ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Severe Traumatic Brain Injury ◽

Neuron Specific Enolase ◽

Acidic Protein ◽

Outcome Predictors ◽

Protein Levels

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Post-operative acute kidney injury is associated with a biomarker of acute brain injury after paediatric cardiac surgery

Cardiology in the Young ◽

10.1017/s1047951120000451 ◽

2020 ◽

Vol 30 (4) ◽

pp. 505-510

Author(s):

Michael Parsons ◽

Jason Greenberg ◽

Chirag Parikh ◽

Jeremiah Brown ◽

Devin Parker ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Kidney Injury ◽

Acidic Protein ◽

Protein Levels ◽

Post Operative Period ◽

Galectin 3

AbstractIntroduction:Children with CHD who undergo cardiopulmonary bypass are at an increased risk of acute kidney injury. This study evaluated the association of end-organ specific injury plasma biomarkers for brain: glial fibrillary acidic protein and heart: Galectin 3, soluble suppression of tumorgenicity 2, and N-terminal pro b-type natriuretic peptide with acute kidney injury in children undergoing cardiopulmonary bypass.Materials and Methods:We enrolled consecutive children undergoing cardiac surgery with cardiopulmonary bypass. Blood samples were collected pre-bypass in the operating room and in the immediate post-operative period. Acute kidney injury was defined as a rise of serum creatinine ≥50% from pre-operative baseline within 7 days after surgery.Results:Overall, 162 children (mean age 4.05 years, sd 5.28 years) were enrolled. Post-operative acute kidney injury developed in 55 (34%) children. Post-operative plasma glial fibrillary acidic protein levels were significantly higher in patients with acute kidney injury (median 0.154 (inter-quartile range 0.059–0.31) ng/ml) compared to those without acute kidney injury (median 0.056 (inter-quartile range 0.001–0.125) ng/ml) (p = 0.043). After adjustment for age, weight, and The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery category, each natural log increase in post-operative glial fibrillary acidic protein was significantly associated with a higher risk for subsequent acute kidney injury (adjusted odds ratio glial fibrillary acidic protein 1.25; 95% confidence interval 1.01–1.59). Pre/post-operative levels of galectin 3, soluble suppression of tumorgenicity 2, and N-terminal pro b-type natriuretic peptide did not significantly differ between patients with and without acute kidney injury.Conclusions:Higher plasma glial fibrillary acidic protein levels measured in the immediate post-operative period were independently associated with subsequent acute kidney injury in children after cardiopulmonary bypass. Elevated glial fibrillary acidic protein likely reflects intraoperative brain injury which may occur in the context of acute kidney injury-associated end-organ dysfunction.

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Faculty Opinions recommendation of Human traumatic brain injury induces autoantibody response against glial fibrillary acidic protein and its breakdown products.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718326742.793539000 ◽

2017 ◽

Author(s):

W Dalton Dietrich

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Acidic Protein ◽

Autoantibody Response

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Changes in Plasma Glial Fibrillary Acidic Protein in Children Receiving Sevoflurane Anesthesia: A Preliminary Randomized Trial

Journal of Clinical Medicine ◽

10.3390/jcm10040662 ◽

2021 ◽

Vol 10 (4) ◽

pp. 662

Author(s):

Eun-Hee Kim ◽

Young-Eun Jang ◽

Sang-Hwan Ji ◽

Ji-Hyun Lee ◽

Sung-Ae Cho ◽

...

Keyword(s):

Glial Fibrillary Acidic Protein ◽

Randomized Trial ◽

Protein Concentration ◽

Pediatric Patients ◽

Neuronal Injury ◽

Acidic Protein ◽

Anesthesia Induction ◽

Sevoflurane Anesthesia ◽

Control Groups ◽

Over Time

We investigated changes in plasma glial fibrillary acidic protein concentration during sevoflurane anesthesia induction in children < 3 years old and determined the effect of co-administering dexmedetomidine. This preliminary randomized trial included 60 pediatric patients who received sevoflurane anesthesia for >3 h. Patients were assigned to dexmedetomidine or control groups at a 1:1 ratio. The primary outcome was changes in plasma glial fibrillary acidic protein concentration of dexmedetomidine and control groups over time. Fifty-five patients were included in the final analysis. The median (interquartile range (IQR)) of the plasma glial fibrillary acidic protein level was 387.7 (298.9–510.8) pg·mL−1 immediately after anesthetic induction, 302.6 (250.9–412.5) pg·mL−1 at 30 min, and 321.9 (233.8–576.2) pg·mL−1 at 180 min after the first sample. These values did not change over time (p = 0.759). However, plasma glial fibrillary acidic protein increased after 180 min of infusion of dexmedetomidine compared with values at 30 min infusion (p = 0.04, mean difference and 95% confidence interval of 221.6 and 2.2 to 441.0 pg·mL−1). In conclusion, three hours of sevoflurane anesthesia in pediatric patients < 3 years old did not provoke neuronal injury assessed by the plasma biomarker. Further studies regarding the effect of prolonged dexmedetomidine infusion on anesthetic neuronal injury are required.

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