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Osteopontin is a Promising Candidate Blood Biomarker for Severe Traumatic Brain Injury in 3. Children; An Investigation of Influence of Systemic Trauma as Measured By Injury Severity Score
Andrew Reisner1, Atul Vats1, Iqbal Sayeed1, *Alexis D Smith1, *John C Bleacher2, Reena R Blanco1, Satyanarayana Gedela1, Michael S. Sawvel1, Scott M. Batchelor2, Amanda J. Pierzchala2, Chia-Yi Kuan3, Joshua J. Chern1, Kimberly M. Hamilton1, Laura S. Blackwell2
1Emory University, Atlanta, GA; 2Childrens Healthcare of Atlanta, Atlanta, GA; 3University of Virginia, Charlottesville, VA

Background (issue):
The goal of this human study was to evaluate whether serum Osteopontin (OPN), a ubiquitous phosphoprotein expressed by many cells including activated microglia, was a more reliable biomarker of traumatic brain injury (TBI) or general systemic trauma in children.
Methods:
This prospective study of pediatric TBI patients was conducted at a Level 1 ACS certified trauma center between March 2018 and October 2019. Admission serum OPN levels were measured using standard ELIZA testing. The degree of neurotrauma was stratified using Glasgow Coma Score (GCS; mild, moderate and severe) and systemic trauma using Injury Severity Score (ISS; mild, moderate, severe and profound). Evaluation of plasma OPN on clinical parameters were analyzed using Pearson correlation and Univariate ANOVA tests.
Findings:
210 patients met study criteria. Mean age was 7.74 years (age 9 months to 18 years), the mean GCS was 11.27 (Range - 3-15) and mean ISS was 14.83 (Range -1-59). Admission OPN correlates with GCS (r=0.322, p<0.01) but not ISS r = .184 (p = .053). Univariate ANOVA of admission OPN and TBI severity revealed significant difference between admission OPN levels across all severity groups (F = 10.594, p <.01), such that higher OPN values were seen in more severe patients; post hoc analyses show severe TBI OPN values are significantly different compared to all other groups.
Conclusions (implications for practice):
Higher initial plasma OPN levels are associated with worsening GCS and not with ISS. OPN is a promising potential biomarker of severity, clinical course, and outcome in TBI rather than overall systemic trauma in children.


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