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Biomolecules
Volume 11
Issue 7
10.3390/biom11071061
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Article

Screening for Fatal Traumatic Brain Injuries in Cerebrospinal Fluid Using Blood-Validated CK and CK–MB Immunoassays

by
Johann Zwirner
1,2,3,*,
Sven Anders
2,
Simone Bohnert
4,
Ralph Burkhardt
5,
Ugo Da Broi
6,
Niels Hammer
7,8,9,
Dirk Pohlers
10,
Rexson Tse
11 and
Benjamin Ondruschka
2,*
1
Department of Anatomy, University of Otago, Dunedin 9016, New Zealand
2
Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany
3
Institute of Legal Medicine, University of Leipzig, 04103 Leipzig, Germany
4
Institute of Forensic Medicine, University of Wuerzburg, 97078 Wuerzburg, Germany
5
Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, 93053 Regensburg, Germany
6
Department of Medicine, Forensic Medicine, University of Udine, 33100 Udine, Italy
7
Institute of Macroscopic and Clinical Anatomy, University of Graz, 8010 Graz, Austria
8
Department of Trauma, Orthopedic and Plastic Surgery, University Hospital of Leipzig, 04103 Leipzig, Germany
9
Fraunhofer Institute for Machine Tools and Forming Technology, 09126 Dresden, Germany
10
Center of Diagnostics, Klinikum Chemnitz, 09116 Chemnitz, Germany
11
Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland 1023, New Zealand
 
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Authors to whom correspondence should be addressed.
Academic Editor: Vladimir N. Uversky
Biomolecules 2021, 11(7), 1061; https://doi.org/10.3390/biom11071061
Received: 4 June 2021 / Revised: 5 July 2021 / Accepted: 17 July 2021 / Published: 20 July 2021
(This article belongs to the Special Issue Postmortem Biochemistry-When Death Matters)
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Abstract

A single, specific, sensitive biochemical biomarker that can reliably diagnose a traumatic brain injury (TBI) has not yet been found, but combining different biomarkers would be the most promising approach in clinical and postmortem settings. In addition, identifying new biomarkers and developing laboratory tests can be time-consuming and economically challenging. As such, it would be efficient to use established clinical diagnostic assays for postmortem biochemistry. In this study, postmortem cerebrospinal fluid samples from 45 lethal TBI cases and 47 controls were analyzed using commercially available blood-validated assays for creatine kinase (CK) activity and its heart-type isoenzyme (CK–MB). TBI cases with a survival time of up to two hours showed an increase in both CK and CK–MB with moderate (CK–MB: AUC = 0.788, p < 0.001) to high (CK: AUC = 0.811, p < 0.001) diagnostic accuracy. This reflected the excessive increase of the brain-type CK isoenzyme (CK–BB) following a TBI. The results provide evidence that CK immunoassays can be used as an adjunct quantitative test aid in diagnosing acute TBI-related fatalities. View Full-Text
Keywords: cerebrospinal fluid; creatine kinase; fatal traumatic brain injury; postmortem biochemistry cerebrospinal fluid; creatine kinase; fatal traumatic brain injury; postmortem biochemistry
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MDPI and ACS Style

Zwirner, J.; Anders, S.; Bohnert, S.; Burkhardt, R.; Da Broi, U.; Hammer, N.; Pohlers, D.; Tse, R.; Ondruschka, B. Screening for Fatal Traumatic Brain Injuries in Cerebrospinal Fluid Using Blood-Validated CK and CK–MB Immunoassays. Biomolecules 2021, 11, 1061. https://doi.org/10.3390/biom11071061

AMA Style

Zwirner J, Anders S, Bohnert S, Burkhardt R, Da Broi U, Hammer N, Pohlers D, Tse R, Ondruschka B. Screening for Fatal Traumatic Brain Injuries in Cerebrospinal Fluid Using Blood-Validated CK and CK–MB Immunoassays. Biomolecules. 2021; 11(7):1061. https://doi.org/10.3390/biom11071061

Chicago/Turabian Style

Zwirner, Johann, Sven Anders, Simone Bohnert, Ralph Burkhardt, Ugo Da Broi, Niels Hammer, Dirk Pohlers, Rexson Tse, and Benjamin Ondruschka. 2021. "Screening for Fatal Traumatic Brain Injuries in Cerebrospinal Fluid Using Blood-Validated CK and CK–MB Immunoassays" Biomolecules 11, no. 7: 1061. https://doi.org/10.3390/biom11071061

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