Mild traumatic brain injuries (mTBI) are prevalent and can result in significant debilitation. Current diagnostic methods have implicit limitations, with clinical assessment tools reliant on subjective self-reported symptoms or non-specific clinical observations, and commonly available imaging techniques lacking sufficient sensitivity to detect mTBI. A blood biomarker would provide a readily accessible detector of mTBI to meet the current measurement gap. Suitable options would provide objective and quantifiable information in diagnosing mTBI, in monitoring recovery, and in establishing a prognosis of resultant neurodegenerative disease, such as chronic traumatic encephalopathy (CTE). A biomarker would also assist in progressing research, providing suitable endpoints for testing therapeutic modalities and for further exploring mTBI pathophysiology. This review highlights the most promising blood-based protein candidates that are expressed in the central nervous system (CNS) and released into systemic circulation following mTBI. To date, neurofilament light (NF-L) may be the most suitable candidate for assessing neuronal damage, and glial fibrillary acidic protein (GFAP) for assessing astrocyte activation, although further work is required. Ultimately, the heterogeneity of cells in the brain and each marker's limitations may require a combination of biomarkers, and recent developments in microRNA (miRNA) markers of mTBI show promise and warrant further exploration.

中文翻译：

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血液生物标志物，用于评估轻度脑外伤和慢性脑外伤。

轻度脑外伤（mTBI）很普遍，可能导致严重的虚弱。当前的诊断方法具有隐含的局限性，其临床评估工具依赖于主观自我报告的症状或非特异性临床观察，并且常用的成像技术缺乏足够的灵敏度来检测mTBI。血液生物标记物将提供易于使用的mTBI检测器，以弥补当前的测量差距。合适的选择将在诊断mTBI，监测恢复以及确定最终的神经退行性疾病（例如慢性创伤性脑病（CTE））的预后方面提供客观和可量化的信息。生物标记物还将协助进行研究，提供合适的终点以测试治疗方式并进一步探索mTBI病理生理学。这篇评论重点介绍了在中枢神经系统（CNS）中表达并在mTBI之后释放到全身循环中最有希望的基于血液的蛋白质候选物。迄今为止，神经丝灯（NF-L）可能是评估神经元损伤的最合适的候选药物，而神经胶质纤维酸性蛋白（GFAP）可能是评估星形胶质细胞活化的最合适的候选药物，尽管还需要进一步的工作。最终，大脑中细胞的异质性和每个标记物的局限性可能需要结合生物标记物，而mTBI的microRNA（miRNA）标记物的最新发展显示出希望并值得进一步探索。神经丝灯（NF-L）可能是评估神经元损伤的最合适的候选药物，而神经胶质纤维酸性蛋白（GFAP）可能是评估星形胶质细胞活化的最合适的候选药物，尽管还需要进一步的工作。最终，大脑中细胞的异质性和每个标记物的局限性可能需要结合生物标记物，而mTBI的microRNA（miRNA）标记物的最新发展显示出希望并值得进一步探索。神经丝光（NF-L）可能是最适合评估神经元损伤的候选药物，而神经胶质纤维酸性蛋白（GFAP）可能是评估星形胶质细胞活化的最合适的候选药物，尽管还需要进一步的工作。最终，大脑中细胞的异质性和每个标记物的局限性可能需要结合生物标记物，而mTBI的microRNA（miRNA）标记物的最新发展显示出希望并值得进一步探索。