THE NEURONAL BIOMARKER NEURON-SPECIFIC ENOLASE CORRELATES WITH THE VOLUME OF LUNG CONTUSION IN POLYTRAUMATIZED PATIENTS

Background: Severe injuries caused by accidents, such as traumatic brain injury (TBI) or thoracic trauma (TT), continue to be the leading cause of death in younger people with relevant socioeconomic impact. Fast and targeted diagnostics is essential for further therapy decisions and prognosis. The following study investigates neuron-specific enolase (NSE) as a potential biomarker for lung injury after blunt TT. Methods: This is a retrospective analysis of prospectively collected data in a level 1 trauma center from 2014 to 2020. Serum levels of NSE and ILs (IL-6, IL-10) in injured patients (n = 41) with isolated TT (Abbreviated Injury Scale score of the thorax ≥3) compared with isolated TBI (Abbreviated Injury Scale score of the head ≥3) were assessed from days 0 to 5 after trauma. The extent of lung injury was quantified by Hounsfield scale in computed tomography scans. Results : Thirty patients with TT (median Injury Severity Score = 20, age 50 ± 17 years, 83.3% were male) and 11 patients with TBI (median Injury Severity Score = 25, age 54 ± 17 years, 27.3% were male) were included. After TT, NSE concentration increased initially after trauma with a peak value on the day of admission (8.51 ± 3.68 ng/mL) compared with healthy controls (4.51 ± 1.504 ng/mL, P < 0.001). Isolated TT and TBI lead to equally strong NSE release ad the day of admission. There is a significant linear relationship ( r = 0.636, P = 0.035) between serum NSE levels and severity of pulmonary contusion at the time of admission and after 24 h. Conclusion : A significant NSE release after isolated TT peaks on the day of admission. The extent of lung contusion volume (defined as alveolar parenchymal density) correlates with NSE serum concentration. Thus, NSE has predictive value for the extent of pulmonary contusion. However, according to these data, NSE seems to have no diagnostic value as a TBI biomarker in concomitant TT.