Breaching the Blood-Brain Barrier

A late-breaking session at the AACC 70th Annual Scientific Meeting & Clinical Lab Expo in Chicago will highlight the uses and implications of the first chemical biomarker test cleared by the U.S. Food and Drug Administration for detecting mild traumatic brain injury (mTBI) or concussion. It will also examine other TBI biomarkers.

“TBI is a very large problem in both civilian and military occupations and activities,” session moderator Robert Christenson, PhD, professor of pathology and professor of medical and research technology at the University of Maryland School of Medicine in Baltimore, told CLN Stat. “Blood is a simple specimen to obtain, and a biomarker would be of great value for rapid rule-out or rule-in of TBI. This would be from economic and, most importantly, patient health reasons,” said Christenson, who is co-presenting with Frank Peacock, MD, professor of emergency medicine at Baylor College of Medicine in Houston, and Robert Welch, MD, director of clinical research at Wayne State University School of Medicine in Detroit.

In his presentation, Christenson plans to cover the interpretation of brain biomarker tests. The speakers also will describe the characteristics of an ideal TBI marker, as well as the evidence for proposed biomarkers that have already been explored. Another discussion will address the seminal trial of the newly cleared test, called Brain Trauma Indicator (BTI), and detail how BTI might be used in emergency department settings.

Detecting TBI in blood is not without its challenges, Christenson emphasized. A blood-brain barrier exists between the blood compartment and the brain compartment. “To determine what brain-specific biomarkers are of high enough concentration to leak over to the blood compartment and be detected in a reasonable time frame after injury has been challenging. There are both biological and technical measurement considerations,” he said.

Clinical laboratorians from all aspects of testing and reimbursement need to understand the inner workings of brain biomarkers, and in particular what the BTI test is—and what it’s not, Christenson indicated. “Interpretation of the test results will also be critical for laboratorians to know, as they will be asked questions about test results by clinicians,” he added.

Participants of this session will be able to:




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