Analysis of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 in Postmortem Serum and Cerebrospinal Fluid in Traumatic Cerebral Deaths

Abstract

Objective: There is a growing body of research aimed at identifying biological markers that could indicate traumatic cerebral deaths such as traumatic brain damage in the postmortem period. In the event of astrocytic and neuronal injury, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) are released into cerebrospinal fluid and blood. In the postmortem identification of traumatic brain injury, the present research explores the ability of GFAP and UCH-L1. Methods: Cerebrospinal fluid and blood samples were obtained from medicolegal autopsies, 17 cases with severe head trauma, 9 cases with the non-lethal head trauma group and 18 control cases. UCH-L1 and GFAP levels in postmortem cerebrospinal fluid and serum were determined from an enzyme-linked immunosorbent assay (ELISA). Results: GFAP level in cerebrospinal fluid and serum was 2.68 +/- 0.67 ng/ml and 0.79 +/- 0.92 ng/ml in the lethal head trauma group, 2.74 +/- 0.64 ng/ml and 1.05 +/- 0.68 ng/ml the non-lethal head trauma group and 2.49 +/- 0.55 ng/ml and 1.05 +/- 0.89 ng/ml in the control group, respectively. UCH-L1 level in cerebrospinal fluid and serum was 3.02 +/- 0.68 ng/ml and 2.69 +/- 0.77 ng/ml in the lethal head trauma group, 3.34 +/- 0.70 ng/ml and 2.59 +/- 0.65 ng/ml the non-lethal head trauma group and 3.28 +/- 0.33 ng/ml and 2.74 +/- 0.34 ng/ml in the control group, respectively. Elevated cerebrospinal fluid and serum UCH-L1 and GFAP levels were observed in all cases, although absence of statistically significant difference between the trauma and control groups (p>0.05). Conclusion: Further studies are needed to assess whether postmortem serum and CSF GFAP and UCH-L1 concentrations increase regardless of the cause of death.