I have posted a number of previous notes about traumatic brain injury (TBI) with some attention to the need for a biomarker to rapidly diagnose the lesion (see, for example: NFL Physician Says Diagnosis of "Chronic Traumatic Encephalopathy" Lacks Validity; Biomarker Proposed to Detect Traumatic Brain Injury; Possible Future Scenarios). Some of my comments have commented on professional football where such a test could change the nature of the game by removing injured players from a game. The first blood test to diagnose traumatic brain injuries has just been approved by the FDA (see: First blood test to help diagnose traumatic brain injuries gets FDA approval). Below is an excerpt from the article:
The first blood test to help doctors diagnose traumatic brain injuries has won U.S. government approval. The move means Banyan Biomarkers can commercialize its test, giving the company an early lead in the biotech industry's race to find a way to diagnose concussions. The test doesn't detect concussions and the approval won't immediately change how patients with suspected concussions or other brain trauma are treated....The test detects two proteins present in brain cells that can leak into the bloodstream following a blow to the head. Banyan's research shows the test can detect them within 12 hours of injury...Patients with a positive test would need a CT scan to confirm the results and determine if surgery or other treatment is needed. The test will first be used in emergency rooms...but Banyan's hope is that it will eventually be used on battlefields and football fields....
The test "sets the stage for a more modernized standard of care for testing of suspected cases"...Traumatic brain injuries affect an estimated 10 million people globally each year; at least 2 million of them are treated in U.S. emergency rooms. They often get CT scans to detect bleeding or other abnormalities....With Department of Defense funding, Banyan's research shows its Brain Trauma Indicator can accurately pick up brain trauma later found on CT scans. It also shows that absence of the two proteins in the test is a good indication that CT scans will be normal...Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke, and other brain injury experts say the test isn't sensitive enough to rule out concussions.....Abbott has licensed both protein biomarkers from Banyan and is developing its own blood tests. BioDirection is developing a test involving one of the proteins in Banyan's test plus another one and using a portable device that can yield results from a single drop of blood in less than two minutes. Quanterix is also working to develop a blood test to diagnose concussions and other brain injuries.
For me, the most interesting aspect of this story is that Banyan scientists have identified two neuroproteins, ubiquitin C-terminal Hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP), that can be used to identify TBI (see: About Biomarkers). The fact that Banyan has licensed both proteins to three other companies to develop tests is significant. Apparently under development by one of them is a rapid test that would obviously have an effect on sports if it comes to market. This whole TBI narrative now seems to have gotten beyond the control of professional football executives who have been successful for years in blocking attempts to diagnose TBI in players. I was not aware of the number of possible TBI's that are encountered yearly in U.S. ERs, discussed in the excerpt above, and the positive effect that the availability of a rapid test would have in avoiding CT scans. This is all good news.
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