Diagnostic significance of ubiquitin C-terminal hydrolase L1 in patients with mine-blast traumatic brain injury

Objective. To assess the diagnostic significance of the UCHL1 protein in mine-blast traumatic brain injury (TBI), to determine its correlation with the severity of brain damage, and to compare its use with conventional diagnostic methods. Material and methods. The study included 253 servicemen with mine-blast TBI of varying severity: mild (n=53), moderate (n=50), and severe (n=150). The serum level of UCHL1 was measured 1, 3, 6, and 12 hours after injury using an enzyme-linked immunosorbent assay. TBI severity was assessed using the Glasgow Coma Scale and neuroimaging data. Statistical processing included analysis of variance (ANOVA), Kruskal—Wallis test, Spearman correlation analysis, logistic regression, and ROC analysis. Results. UCHL1 levels statistically significantly correlated with TBI severity (ρ=0.66, p<0.001). The levels were significantly higher in patients with severe TBI compared with those with mild or moderate TBI. Analysis of the ROC curve showed high diagnostic sensitivity of UCHL1 for severe TBI (AUC=0.83). However, the temporal change in UCHL1 demonstrated limited predictive value, highlighting the need for a multi-biomarker approach. Conclusion. UCHL1 is a promising biomarker for the early diagnosis and stratification of patients with mine-blast TBI. However, its limited change variability reduces its value for monitoring. The combined use of UCHL1 with other biomarkers (GFAP, NSE, and MAPt) and neuroimaging can improve the accuracy of diagnosis and outcome prediction, especially during the prehospital stage of medical care.