Brain trauma detected by a drop of blood

UNIGE researchers developed a portable case that can diagnose a mild traumatic brain injury in a patient in just ten minutes using a single drop of blood. Commercialized in 2019, this discovery will relieve emergencies, free patients from often long wait, but also save on expensive medical examinations.

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Falling downhill, falling down the stairs or taking a blow to the head … every year in Europe, three million people are admitted to hospital because of suspicion of traumatic brain injury light . A condition that causes symptoms such as blurred vision, vomiting, loss of consciousness or memory for about 30 minutes. However, 90% of these patients will be able to return home without risk, as no trauma has been detected, say researchers at the University of Geneva. Conversely, Inserm states that among patients who present only minor lesions, up to 20% see their neurological state e deteriorate in the following week.

Doctors must therefore know precisely if it is really a brain injury or if these symptoms are only the temporary consequence of the violence of the shock. Today, the only reliable diagnosis is CT Scan, an examination available in some hospitals that, in addition to being expensive, exposes to radiation (X-rays in the brain). Add to this an often long wait for these patients whose case is not always a priority. Swiss researchers have therefore wondered whether it is not possible to develop an alternative examination to isolate certain proteins whose presence in the blood increases in case of mild traumatic brain injury.

Find the biomarkers of mild traumas

"Our idea was to find a way to make a quick examination that would tell if an athlete can return to the field or if his condition requires hospitalization . The opposite of CT Scan, a test that lasts a long time and can not be done anywhere. "Says Professor Jean-Charles Sanchez, of the Faculty of Medicine of UNIGE. During a shock to the head, some brain cells are damaged and release into the bloodstream the proteins they contain. The scientists then compared the blood of patients admitted for mild traumatic brain injury but diagnosed negative, with that of patients who had mild traumatic brain injury

Thanks to "proteomic" type allow to quantify thousands of proteins simultaneously and to observe the changes in their level in the blood, they gradually isolated four molecules indicating the presence of a mild traumatic brain injury: H-FABP, Interleukin-10 , S100B and GFAP. "We have noticed that the level of H-FABP alone makes it possible to affirm that there is no risk of trauma in a third of the patients admitted after a shock. "Adds Professor Jean-Charles Sanchez. The rest of the patients will go for a CT scan to confirm the diagnosis. It was still necessary to develop a device to make the examination everywhere, quickly.

Commercialization planned for 2019

The goal would be to be able to get it in pharmacy and even in sports halls. "When a person has an accident in the mountains, few are the cabinets that can make a CT scan." reports the researcher from Geneva. His team has therefore developed a rapid diagnostic test called TBIcheck, inspired by the principle of the pregnancy test: by placing a drop of blood on the tongue of a small plastic case, the patient knows in 10 minutes whether There is a risk of mild trauma, namely if its H-FABP level is greater than 2.5 nanograms per milliliter of blood. "If a band appears the injured must go for a CT scan, if there is nothing, he can return home safely.", Says Jean-Charles Sanchez.

In case Doubtful when reading the result, a small reader may be asked on the TBIcheck who will write positive or negative and will send the result on the smartphone of the patient or caregiver. These results, patented by UNIGE have already been rewarded by the "Innovation Academy Award" in December 2017. The next step is to market the device in 2019 by ABCDx, a start-up founded four years ago by Professor Jean-Charles Sanchez and Joan Montaner from the Vall d'Hebron Hospital in Barcelona, ​​co-author of this study. "Our research shows that the results are even more accurate when we combine the rates of H-FABP and GFAP ." Continues Jean-Charles Sanchez.

"We are in the process of prepare an even better TBIcheck which will send home 50% of patients, but which requires an increase in the sensitivity of the tongue that receives the blood. He says. Eventually, the goal of the start-up ABCDx is to market biomarkers able to diagnose traumatic brain injury, but also cerebrovascular accidents and aneurysms (abnormal dilation of a portion of artery, whose weakened wall deforms and may break). "Biomarkers are a mine of information on the state of health of patients, it is up to us to know how to decode them", concludes the researcher from Geneva.