Accuracy of Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-Terminal Hydrolase 1 (UCHl-1) as Indicators of Brain Damage Among Acute and Chronic Drug Abuse Cases Presented to Benha Governmental Hospitals

Hassan, Karim Taha; Algendy, Ibrahim; Hindawy, Rabab; Elsharkawey, Sally

doi:10.21608/bfstj.2025.400946.1025

Accuracy of Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-Terminal Hydrolase 1 (UCHl-1) as Indicators of Brain Damage Among Acute and Chronic Drug Abuse Cases Presented to Benha Governmental Hospitals

Document Type : Original Article

Authors

¹ Forensic medicine and Clinical toxicology department Benha university

² Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Benha University

³ associate professor forensic medicine and clinical toxicology, faculty of medicine, Benha university, Egypt

⁴ forensic medicine and clinical toxicology

10.21608/bfstj.2025.400946.1025

Abstract

Background: Substance abuse disorder (SAD) is characterized by excessive drug use affecting brain function, behavior, and memory. Early detection of brain damage in SAD patients is crucial for timely intervention and prevention of long-term complications.

Aim: This study aimed to evaluate the accuracy of two brain biomarkers, glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCHL-1), in detecting brain injury among acute and chronic drug abuse cases presenting to Benha governmental hospitals, including Benha Poisoning Treatment and Research Unit (BPTRU) and Benha Mental Health Hospital.

Methods: A prospective cross-sectional study was conducted on 200 patients with confirmed SAD diagnoses from September 2022 to March 2023. Patients were divided into two equal groups: acute cases presenting with recent drug use complications and chronic cases with a known history of long-term drug abuse. All patients underwent full clinical evaluation and laboratory investigations, including serum levels of GFAP and UCHL-1.

Results: GFAP demonstrated high accuracy in distinguishing between acute and chronic SAD cases, while UCHL-1 showed high diagnostic accuracy with an area under the curve (AUC) of 0.906. GFAP levels had a significant positive correlation with UCHL-1 levels and substance measurements. Similarly, UCHL-1 demonstrated a significant positive correlation with GFAP levels and substance measurements.

Conclusions: Acute SAD cases exhibited significantly higher GFAP and UCHL-1 levels compared to chronic cases. These findings suggest that GFAP and UCHL-1 could serve as potential biomarkers for detecting brain injury severity in substance abuse disorders, aiding in early diagnosis and management strategies.

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