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Putative Concussion Biomarkers Identified in Adolescent Male Athletes Using Targeted Plasma Proteomics
Frontiers in Neurology
  • Michael R. Miller, The University of Western Ontario
  • Michael Robinson, The University of Western Ontario
  • Lisa Fischer, The University of Western Ontario
  • Alicia DiBattista, Children's Hospital of Eastern Ontario, Ottawa
  • Maitray A. Patel, The University of Western Ontario
  • Mark Daley, The University of Western Ontario
  • Robert Bartha, The University of Western Ontario
  • Gregory A. Dekaban, Robarts Research Institute
  • Ravi S. Menon, The University of Western Ontario
  • J. Kevin Shoemaker, The University of Western Ontario
  • Eleftherios P. Diamandis, University of Toronto
  • Ioannis Prassas, University of Toronto
  • Douglas D. Fraser, The University of Western Ontario
Document Type
Article
Publication Date
12-20-2021
URL with Digital Object Identifier
10.3389/fneur.2021.787480
Disciplines
Abstract

Sport concussions can be difficult to diagnose and if missed, they can expose athletes to greater injury risk and long-lasting neurological disabilities. Discovery of objective biomarkers to aid concussion diagnosis is critical to protecting athlete brain health. To this end, we performed targeted proteomics on plasma obtained from adolescent athletes suffering a sports concussion. A total of 11 concussed male athletes were enrolled at our academic Sport Medicine Concussion Clinic, as well as 24 sex-, age- and activity-matched healthy control subjects. Clinical evaluation was performed and blood was drawn within 72 h of injury. Proximity extension assays were performed for 1,472 plasma proteins; a total of six proteins were considered significantly different between cohorts (P < 0.01; five proteins decreased and one protein increased). Receiver operating characteristic curves on the six individual protein biomarkers identified had areas-under-the-curves (AUCs) for concussion diagnosis ≥0.78; antioxidant 1 copper chaperone (ATOX1; AUC 0.81, P = 0.003), secreted protein acidic and rich in cysteine (SPARC; AUC 0.81, P = 0.004), cluster of differentiation 34 (CD34; AUC 0.79, P = 0.006), polyglutamine binding protein 1 (PQBP1; AUC 0.78, P = 0.008), insulin-like growth factor-binding protein-like 1 (IGFBPL1; AUC 0.78, P = 0.008) and cytosolic 5'-nucleotidase 3A (NT5C3A; AUC 0.78, P = 0.009). Combining three of the protein biomarkers (ATOX1, SPARC and NT5C3A), produced an AUC of 0.98 for concussion diagnoses (P < 0.001; 95% CI: 0.95, 1.00). Despite a paucity of studies on these three identified proteins, the available evidence points to their roles in modulating tissue inflammation and regulating integrity of the cerebral microvasculature. Taken together, our exploratory data suggest that three or less novel proteins, which are amenable to a point-of-care immunoassay, may be future candidate biomarkers for screening adolescent sport concussion. Validation with protein assays is required in larger cohorts.

Citation Information
Michael R. Miller, Michael Robinson, Lisa Fischer, Alicia DiBattista, et al.. "Putative Concussion Biomarkers Identified in Adolescent Male Athletes Using Targeted Plasma Proteomics" Frontiers in Neurology Vol. 12 (2021)
Available at: http://works.bepress.com/kevin-shoemaker/67/