Lindblad C, Pin E, Just D, Al Nimer F, Nilsson P, Bellander BM, Svensson M, Piehl F, Thelin EP. Fluid proteomics of CSF and serum reveal important neuroinflammatory proteins in blood-brain barrier disruption and outcome prediction following severe traumatic brain injury: a prospective, observational study. Crit Care. 2021 Mar 12;25(1):103. PMID: 33712077

Severe traumatic brain injury (TBI) is a major cause of death and disability worldwide. Current diagnostic tools fail to fully capture the complexity of secondary injury mechanisms, such as blood–brain barrier (BBB) breakdown and chronic inflammation. 

A groundbreaking proteomic study has provided the largest dataset to date on how BBB disruption and neuroinflammation influence long-term outcomes in severe TBI patients.

???? Atlas Antibodies and The Human Protein Atlas played a key role by providing 220 polyclonal antibodies used in a suspension bead array, enabling high-throughput screening of 177 proteins (full list of antibodies in Suppl. Material, Table 1).

These antibodies were immobilized on color-coded magnetic beads and analyzed using affinity proteomics (FlexMap 3D Luminex platform).

The HPA-based antibody selection focused on CNS-enriched, neuroinflammatory, and BBB-related proteins. Results show 114 proteins (mainly linked to neuroinflammation and immune response) correlated with BBB integrity.

Identified biomarkers included:

Astrocytic proteins: S100B, GFAP

Neuronal proteins: NSE, NFL

Complement system proteins: C9, CFB

The identified proteins could help refine biomarker models for diagnosis, prognosis, and therapeutic targeting. The findings highlight that complement activation, a key immune response mechanism, predicts both BBB integrity and patient recovery.

This study offers new hope for developing personalized treatment strategies based on biomarker profiles.