Brain- and heart-type fatty acid-binding proteins in the brain: Tissue distribution and clinical utility

Maurice M. A. L. Pelsers, Thorsten Hanhoff, Daniëlle van der Voort, Baer Arts, Maarten Peters, Rudolf Ponds, Adriaan Honig, Wojtek Rudzinski, Friedrich Spener, Jelle R. de Kruijk, Albert Twijnstra, Wim T. Hermens, Paul P. C. A. Menheere, Jan F. C. Glatz

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Background: Detection of brain injury by serum markers is not a standard procedure in clinical practice, although several proteins, such as S100B, neuron-specific enolase (NSE), myelin basic protein, and glial fibrillary acidic protein, show promising results. We investigated the tissue distribution of brain- and heart-type fatty acid-binding proteins (B-FABP and H-FABP) in segments of the human brain and the potential of either protein to serve as plasma marker for diagnosis of brain injury. Methods: B-FABP and H-FABP were measured immunochemically in autopsy samples of the brain (n = 6) and in serum samples from (a) patients with mild traumatic brain injury (MTBI; n = 130) and (b) depressed patients undergoing bilateral electroconvulsive therapy (ECT; n = 14). The protein markers S100B and NSE were measured for comparison. Reference values of B-FABP and H-FABP were established in healthy individuals (n = 92). Results: The frontal, temporal, and occipital lobes, the striatum, the pons, and the cerebellum had different tissue concentrations of B-FABP and of H-FABP. B-FABP ranged from 0.8 μg/g wet weight in striatum tissue to 3.1 μg/g in frontal lobe. H-FABP was markedly higher, ranging from 16.2 μg/g wet weight in cerebellum tissue to 39.5 μg/g in pons. No B-FABP was detected in serum from healthy donors. H-FABP serum reference value was 6 μg/L. In the MTBI study, serum B-FABP was increased in 68% and H-FABP in 70% of patients compared with S100B (increased in 45%) and NSE (increased in 51% of patients). In ECT, serum B-FABP was increased in 6% of all samples (2 of 14 patients), whereas H-FABP was above its upper reference limit (6 μg/L) in 17% of all samples (8 of 14 patients), and S100B was above its upper reference limit (0.3 μg/L) in 0.4% of all samples. Conclusions: B-FABP and H-FABP patterns differ among brain tissues, with the highest concentrations in the frontal lobe and pons, respectively. However, in each part of the brain, the H-FABP concentration was at least 10 times higher than that of B-FABP. Patient studies indicate that B-FABP and H-FABP are more sensitive markers for minor brain injury than the currently used markers S100B and NSE. © 2004 American Association for Clinical Chemistry.
Original languageEnglish
Pages (from-to)1568-1575
JournalClinical Chemistry
Issue number9
Publication statusPublished - Sept 2004
Externally publishedYes

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