The role of spectrin breakdown products in patients with traumatic brain injury: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Spectrin Breakdown Products (SBDPs) accumulate in the brain after traumatic brain injury (TBI) and are expected to become a potentially promising biomarker of TBI. OBJECTIVE: This systematic review and meta-analysis were undertaken to evaluate the role of SBDPs in the diagnosis and prognosis of TBI. METHODS: We systematically searched the following databases up to 31 October 2022 Ovid MEDLINE, PubMed, EMBASE, Cochrane Library, and Web of Science Database, and studies were only included if they had sufficient data on SBDP concentrations in TBI patients. We calculated the standardized mean differences (SMDs) and 95% confidence intervals (CIs) for continuous outcomes and assessed the potential publication bias by using Egger's test and funnel plots. The statistical analysis was conducted by RevMan 5.4 and Stata 17. RESULTS: Of 1429 identified studies, 10 studies involving 417 participants were included in our systematic review and meta-analysis. The results demonstrated that serum and cerebrospinal fluid (CSF) SBDP concentrations were significantly increased in TBI compared to controls (SBDP120 SMD = 1.42, 95% CI = 0.71 ~ 2.12, P < 0.00001; SBDP145 SMD = 1.32, 95% CI = 0.78 ~ 1.86, P < 0.00001; SBDP150 SMD = 1.39, 95% CI = 0.97 ~ 1.80, P < 0.00001), and CSF SBDPs were significantly associated with poor functional outcomes (PFO) (SBDP145 SMD = 1.75, 95% CI = 1.37 ~ 2.13, P < 0.00001; SBDP150 SMD = 1.14, 95% CI = 0.75 ~ 1.52, P < 0.00001). In addition, CSF and serum SBDP145 are valuable in diagnosing TBI (AUC = 0.89, 95% CI = 0.80 ~ 0.99, P < 0.00001), and CSF SBDP145 also has diagnostic value for PFO (AUC = 0.80, 95% CI = 0.76 ~ 0.84, P < 0.00001). CONCLUSIONS: The limited evidence supports that the SBDPs can be employed as potential biomarkers for the diagnosis and prognosis of TBI.