Journal Article (Review Article)

DZNE-2022-00722

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Blood GFAP as an emerging biomarker in brain and spinal cord disorders.

Abdelhak, A. ; Foschi, M. ; Abu-Rumeileh, S. ; Yue, J. K. ; D'Anna, L. ; Huss, A. ; Oeckl, P.DZNE* ; Ludolph, A. C.DZNE* ; Kuhle, J. ; Petzold, A. ; Manley, G. T. ; Green, A. J. ; Otto, M. ; Tumani, H.Extern*

2022
Macmillan Publishers Limited, part of Springer Nature London

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Please use a persistent id in citations: doi:10.1038/s41582-021-00616-3

Abstract: Blood-derived biomarkers for brain and spinal cord diseases are urgently needed. The introduction of highly sensitive immunoassays led to a rapid increase in the number of potential blood-derived biomarkers for diagnosis and monitoring of neurological disorders. In 2018, the FDA authorized a blood test for clinical use in the evaluation of mild traumatic brain injury (TBI). The test measures levels of the astrocytic intermediate filament glial fibrillary acidic protein (GFAP) and neuroaxonal marker ubiquitin carboxy-terminal hydrolase L1. In TBI, blood GFAP levels are correlated with clinical severity and extent of intracranial pathology. Evidence also indicates that blood GFAP levels hold the potential to reflect, and might enable prediction of, worsening of disability in individuals with progressive multiple sclerosis. A growing body of evidence suggests that blood GFAP levels can be used to detect even subtle injury to the CNS. Most importantly, the successful completion of the ongoing validation of point-of-care platforms for blood GFAP might ameliorate the decision algorithms for acute neurological diseases, such as TBI and stroke, with important economic implications. In this Review, we provide a systematic overview of the evidence regarding the utility of blood GFAP as a biomarker in neurological diseases. We propose a model for GFAP concentration dynamics in different conditions and discuss the limitations that hamper the widespread use of GFAP in the clinical setting. In our opinion, the clinical use of blood GFAP measurements has the potential to contribute to accelerated diagnosis and improved prognostication, and represents an important step forward in the era of precision medicine.

Keyword(s): Biomarkers (MeSH) ; Brain (MeSH) ; Glial Fibrillary Acidic Protein (MeSH) ; Humans (MeSH) ; Intermediate Filaments (MeSH) ; Spinal Cord Diseases: diagnosis (MeSH) ; Biomarkers ; Glial Fibrillary Acidic Protein

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Contributing Institute(s):

1. Translational Mass Spectrometry and Biomarker Research (AG Öckl)
2. Clinical Study Center (Ulm) (Clinical Study Center (Ulm))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 40 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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