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National Neurotrauma Society


July 11-14, 2021



The National Neurotrauma Society is committed to the promotion of neurotrauma research by enhancing communications, providing a forum, and increasing support on the national and international level. The National Neurotrauma Society seeks to accelerate research that will provide answers for clinicians and ultimately improve the treatments available to patients. The National Neurotrauma Society will continue to promote excellence in the field by providing opportunities for scientists, establishing standards in both basic and clinical research, encouraging and supporting research, and promoting liaisons with other organizations that influence the care and cure of neurotrauma victims.

Quanterix will be participating in the conference with a virtual exhibit. Chat with our Simoa® experts to learn about the advances that ultra-sensitive Simoa technology continues to make in the study of neurology by enabling researchers to quantify biomarkers of TBI and other neurological injuries at fg/mL levels in blood.

Sponsored Symposium:
S09 – Emerging Trends in Molecular TBI Biomarkers
4:00-5:15pm ET, Monday, July 12

Posters featuring Simoa technology:

Joshua Wiener1, Leah Vaughn1, Kevin Wang2, Amy Wagner1
1 University of Pittsburgh, Department of Physical Medicine and
  Rehabilitation, Pittsburgh, USA
2 University of Florida, Department of Emergency Medicine,
  Gainesville, USA

Traumatic brain injury (TBI) triggers an auto­immune re­sponse to glial fibrillary acid pro­tein (GFAP), a filament pro­tein ex­pressed by astro­cytes in the CNS, which may manifest in serum as well through elevated GFAP and anti-GFAP auto­anti­bodies (AGA) immuno­globulin (Ig)M and IgG. We aimed to char­acter­ize this re­sponse by col­lection of serial serum samples through month-six post-injury from n=361 individuals with moderate-to-severe-TBI. GFAP was measured via Quanterix SIMOA and AGA IgM and IgG by a customized ELISA. Biomarker data was ag­gre­gated in­to Day-0-6 and Month-1-6 means for analysis. Demographic and clinical factors were assessed and outcome measures using Disability Rating Scale (DRS) and Glasgow Outcome Scale (GOS) scores at 6- and 12-months post-TBI. Longitudinal bio­marker patterns were char­acter­ized Day-0-6 and Month-1-6 by group-based trajectory (TRAJ) analysis. GFAP TRAJs showed decreasing trends over Day-0-6 and Month-1-6 while AGA IgM and IgG TRAJ pro­files were zero-order over both time periods. Longitudinal (Day-0-6 vs. Month-1-6) cor­rel­ations were evident for each bio­marker. Day-0-6 GFAP TRAJs were linked to AGA ex­pression over time, wherein the high GFAP TRAJ had higher AGA IgG and lower IgM:IgG in both time epochs. Older age was as­so­ci­ated with higher Day-0-6 GFAP and AGA IgG and lower Day-0-6 and Month-1-6 AGA IgM and AGA IgM:IgG. Higher AGA IgG and lower AGA IgM:IgG at Day-0-6 were as­so­ci­ated with worse DRS at 6- and 12-months post-injury. Month-1-6 AGA as­so­ci­ations to outcome were not evident. Higher GFAP levels, however, at both Day-0-6 and Month-1-6, were as­so­ci­ated with worse DRS and GOS score. These find­ings further motivate the char­acter­ization and mechanistic exploration of serum GFAP and AGA rela­tion­ships to global re­cov­ery post-TBI. 

Vivian Guedes2, Sara Mithani2, Ethan Smith2, Dilorom Sass2, Cyndi Williams1, Jessica Gill2Holly Hinson1
1 Oregon Health and Science University, Neurology, Portland,
2 National Institute of Nursing Research, Division of Intramural
  Research, Bethesda, USA

Introduction: Extracellular vesicles (EVs) are mem­brane-bound vesicles that play a role in in­tra­cellular com­mu­nication. EVs are an emerging bio­marker after traumatic brain injury (TBI), as their lipid bilayer confers relative stability.
Methods: A subset of subjects from a pro­spective, observational trial with major trauma admitted to ICU were analyzed. Here, we included subjects with Multiple Injuries and Isolated Body Injury based on the Abbreviated Injury Severity Scores (AIS). Admission plasma samples were obtained within 6-12 hours of trauma. Total EV levels of glial (glial fibrillary acidic pro­tein (GFAP)) and neu­ronal/axonal (ubiquitin carbo­xy-terminal hydrolase L1 (UCH-L1), neuro­filament light chain (NFL), and total-tau (t-tau)) pro­teins were measured using single mole­cule array (Simoa) technology and reported in pg/mL. Continuous variables were com­pared with t-tests; categorical variables with chi-squared tests. Correlations were measured with a Spearman’s cor­rel­ation coefficient. Significance was set at P < 0.05.
Results: Patients with multi­ple injuries (n=41) and isolated body injury (n=73) were of similar age (47 +/- 17 v. 47 +/- 17 years, P=0.98) and pre­dominately male (71% v. 74%, P=0.88). Patients with multi­ple injuries were as expected, more severely injured with higher injury severity scores (29 [26-41] v. 21 [14-26], P < 0.001), and lower GCS scores (12[4-13] v. 13[13-13], P < 0.001). Total body con­cen­tration EVs of GFAP, UCH-L1, and NFL were higher in those with multi­ple injuries (1768 [932-4780] v. 239 [63-589], P < 0.001), (75.4 [47.8-158.3] v. 41.5 [21.5-67.1], P=0.03), and (7.5 [3.3-12.3] v. 2.9 [2.1-4.8], P < 0.001), respectively. There was a weak, but sig­nifi­cant cor­rel­ation be­tween total injury severity score and 3 of the pro­teins (GFAP ρ=0.46, P < 0.001; UCHL-1 ρ=0.38, P < 0.001; NFL ρ=0.36, P < 0.001).
Conclusion: While sig­nifi­cantly higher in patients with TBI, EVs containing CNS damage as­so­ci­ated pro­teins are pre­sent in trauma patients without clinically sig­nifi­cant TBI. GFAP, UCH-L1, and NFL EVs weakly cor­rel­ate to total injury severity. 

If you would like to know more about how Simoa technology powers advances in TBI research in advance of this meeting, please review Simoa neurology publications or speak to a representative today!