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PLoS One. 2018 Dec 31;13(12):e0210128. doi: 10.1371/journal.pone.0210128. eCollection 2018.

Inflammasome proteins as biomarkers of traumatic brain injury.

Author information

1
Department of Neurological Surgery, Neuroscience Program, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, United States of America.
2
Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami FL, United States of America.
3
Intensive Care Department, Son Espases Hospital, Palma de Mallorca, Spain.
4
Fundacio Institut d'Investigacio Sanitaria Illes Balears (IdISBa), Son Espases Hospital, Palma de Mallorca, Spain.
5
Department of Neurological Surgery, Son Espases Hospital, Palma de Mallorca, Spain.
6
Department of Neurological Surgery, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, United States of America.

Abstract

BACKGROUND:

The inflammasome plays an important role in the inflammatory innate immune response after central nervous system (CNS) injury. Inhibition of the inflammasome after traumatic brain injury (TBI) results in improved outcomes by lowering the levels of caspase-1 and interleukin (IL)-1b. We have previously shown that inflammasome proteins are elevated in the cerebrospinal fluid (CSF) of patients with TBI and that higher levels of these proteins were consistent with poorer outcomes after TBI when compared to patients that presented these inflammasome proteins at lower levels.

METHODS AND FINDINGS:

Here we extend our work by analyzing serum from 21 TBI patients and CSF from 18 TBI patients compared to 120 serum samples and 30 CSF samples from no-TBI donor controls for the expression of caspase-1, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), interleukin(IL)-1b and IL-18. Analysis was carried out using the Ella Simple Plex system (Protein Simple) to determine the sensitivity and specificity of inflammasome proteins as biomarkers of TBI. Receiver operator characteristic (ROC) curves, confidence intervals and likelihood ratios for each biomarker was determined. ROC curves, confidence intervals, sensitivity and specificity for each biomarker examined revealed that caspase-1 (0.93 area under the curve (AUC)) and ASC (0.90 AUC) in serum and ASC (1.0 AUC) and IL-18 (0.84 AUC) in CSF are promising biomarkers of TBI pathology. Importantly, higher protein levels (above 547.6 pg/ml) of ASC (0.91 AUC) were consistent with poorer outcomes after TBI as determined by the Glasgow Outcome Scale-Extended (GOSE).

CONCLUSION:

These findings indicate that inflammasome proteins are excellent diagnostic and predictive biomarkers of TBI.

Conflict of interest statement

JPdRV, RWK and WDD are co-founders and managing members of InflamaCORE, LLC and have patents on inflammasome proteins as biomarkers of injury and disease as well as on targeting inflammasome proteins for therapeutic purposes. Data presented in this manuscript is protected under US Patent Application: 62/560,963 (Method for Detecting Inflammasome Proteins as Biomarkers of Neurological Disorders). This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

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