Ursula K Rohlwink1, Anthony A Figaji2. 1. Paediatric Neurosurgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. ursulakarin@gmail.com. 2. Paediatric Neurosurgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Abstract
BACKGROUND: Central nervous system (CNS) infections present a major burden of disease worldwide and are associated with high rates of mortality and morbidity. Swift diagnosis and initiation of appropriate treatment are vital to minimize the risk of poor outcome; however, tools are lacking to accurately diagnose infection, assess injury severity, and predict outcome. Biomarkers of structural neurological injury could provide valuable information in addressing some of these challenges. CONTENT: In this review, we summarize experimental and clinical research on biomarkers of neurological injury in a range of CNS infectious diseases. Data suggest that in both adults and children, the biomarkers S100B and neuron-specific enlose (NSE), among others, can provide insight into the pathophysiology of CNS infection and injury severity, evolution, and response to treatment. Research into the added utility of combining a panel of biomarkers and in assessing biomarker association with clinical and radiological outcomes warrants further work. Various factors, including age, the establishment of normative values, and comparison of biomarker concentrations across different testing platforms still present challenges in biomarker application. SUMMARY: Research regarding the value of biomarkers in CNS infections is still in its infancy. However, early evidence supports their utility in diagnosis and prognosis, and potentially as effective surrogate end points in the assessment of novel interventions.
BACKGROUND:Central nervous system (CNS) infections present a major burden of disease worldwide and are associated with high rates of mortality and morbidity. Swift diagnosis and initiation of appropriate treatment are vital to minimize the risk of poor outcome; however, tools are lacking to accurately diagnose infection, assess injury severity, and predict outcome. Biomarkers of structural neurological injury could provide valuable information in addressing some of these challenges. CONTENT: In this review, we summarize experimental and clinical research on biomarkers of neurological injury in a range of CNS infectious diseases. Data suggest that in both adults and children, the biomarkers S100B and neuron-specific enlose (NSE), among others, can provide insight into the pathophysiology of CNS infection and injury severity, evolution, and response to treatment. Research into the added utility of combining a panel of biomarkers and in assessing biomarker association with clinical and radiological outcomes warrants further work. Various factors, including age, the establishment of normative values, and comparison of biomarker concentrations across different testing platforms still present challenges in biomarker application. SUMMARY: Research regarding the value of biomarkers in CNS infections is still in its infancy. However, early evidence supports their utility in diagnosis and prognosis, and potentially as effective surrogate end points in the assessment of novel interventions.
Authors: Ursula K Rohlwink; Katya Mauff; Katalin A Wilkinson; Nico Enslin; Emmanuel Wegoye; Robert J Wilkinson; Anthony A Figaji Journal: Clin Infect Dis Date: 2017-10-15 Impact factor: 9.079
Authors: Steven T DeKosky; Patrick M Kochanek; Alex B Valadka; Robert S B Clark; Sherry H-Y Chou; Alicia K Au; Christopher Horvat; Ruchira M Jha; Rebekah Mannix; Stephen R Wisniewski; Max Wintermark; Susan E Rowell; Robert D Welch; Lawrence Lewis; Stacey House; Rudolph E Tanzi; Darci R Smith; Amy Y Vittor; Nancy D Denslow; Michael D Davis; Olena Y Glushakova; Ronald L Hayes Journal: J Neurotrauma Date: 2020-11-11 Impact factor: 5.269