Assessing a Blast Related Biomarker in an Operational Community: GFAP in Experienced Breachers.

Tschiffely AE1, Statz JK2, Edwards K3, Goforth CW4, Ahlers S5, Carr W6, Gill J7.

Author information

1: Naval Medical Research Center, 19930, Neurotrauma, Silver Spring, Maryland, United States; anna.e.tschiffely.ctr@mail.mil.
2: Naval Medical Research Center, 19930, Neurotrauma, Silver Spring, Maryland, United States; jonathan.k.statz.ctr@mail.mil.
3: National Institutes of Health, 2511, National Institute of Nursing Research, Bethesda, Maryland, United States; katie.edwards@nih.gov.
4: Naval Medical Research Center, 19930, Neurotrauma, Silver Spring, Maryland, United States; carl.w.goforth.mil@mail.mil.
5: Naval Medical Research Center, 19930, Neurotrauma, Silver Spring, Maryland, United States; stephen.t.ahlers.civ@mail.mil.
6: Walter Reed Army Institute of Research, 8394, Silver Spring, Maryland, United States; walter.s.carr.ctr@mail.mil.
7: National Institutes of Health, 2511, National Institute of Nursing Research, Bethesda, Maryland, United States; gillj@mail.nih.gov.

Abstract

Mild traumatic brain injury (mTBI) is a risk for military personnel due to blast overpressures, which may result from a variety of sources, including artillery and improvised explosive devices. Much research has gone into the search for a biomarker to identify patients with a TBI. The FDA recently identified two proteins, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1), as biomarkers to evaluate suspected brain injury. Our group previously observed changes in UCH-L1 in a military population exposed to repeated blast. In our current study we assessed GFAP protein levels in a military population exposed to repeated blast during a 2-week training protocol. We observed GFAP levels were reduced in the moderate blast cases on days 6 and 7 during the training. Specifically, moderate blast cases showed a 24.07% reduction from baseline on day 6 and a 29.61% reduction on day 7. Furthermore, GFAP levels were negatively correlated with cumulative blast experienced during training and with duration of military service. We observed that repeated blast exposure at low levels may impact acute changes in GFAP. Additionally sub-acute cumulative blast exposure or duration of service was also a factor in influencing GFAP levels.