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Cralley AL, Erickson C, Schaid TR, Hallas W, Thielen O, Mitra S, Stafford P, Hom P, Silliman C, Cohen MJ, Moore EE, D'Alessandro A, Hansen KC. The proteomic and metabolomic signatures of isolated and polytrauma traumatic brain injury. Am J Surg 2023; 226:790-797. [PMID: 37541795 DOI: 10.1016/j.amjsurg.2023.07.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/02/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The interactions of polytrauma, shock, and traumatic brain injury (TBI) on thromboinflammatory responses remain unclear and warrant investigation as we strive towards personalized medicine in trauma. We hypothesized that comprehensive omics characterization of plasma would identify unique metabolic and thromboinflammatory pathways following TBI. METHODS Patients were categorized as TBI vs Non-TBI, and stratified into Polytrauma or minimally injured. Discovery 'omics was employed to quantify the top differently expressed proteins and metabolites of TBI and Non-TBI patient groups. RESULTS TBI compared to Non-TBI showed gene enrichment in coagulation/complement cascades and neuronal markers. TBI was associated with elevation in glycolytic metabolites and conjugated bile acids. Division into isolated TBI vs polytrauma showed further distinction of proteomic and metabolomic signatures. CONCLUSION Identified mediators involving in neural inflammation, blood brain barrier disruption, and bile acid building leading to TBI associated coagulopathy offer suggestions for follow up mechanistic studies to target personalized interventions.
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Affiliation(s)
| | - Chris Erickson
- Department of Proteomics and Metabolomics, University of Colorado, Aurora, CO, USA
| | - Terry R Schaid
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - William Hallas
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - Otto Thielen
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | | | | | - Patrick Hom
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - Christopher Silliman
- Vitalant Research Institute, Denver, CO, USA; Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | | | - Ernest E Moore
- Department of Surgery, University of Colorado, Aurora, CO, USA; Ernest E. Moore Shock Trauma Center at Denver Health Medical Center Surgery, Aurora, CO, USA
| | - Angelo D'Alessandro
- Department of Proteomics and Metabolomics, University of Colorado, Aurora, CO, USA
| | - Kirk C Hansen
- Department of Proteomics and Metabolomics, University of Colorado, Aurora, CO, USA
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Chakraborty T, Wijdicks E. A Punch to the Gut from a Ruptured Cerebral Aneurysm. Neurocrit Care 2020; 34:343-344. [PMID: 32232725 DOI: 10.1007/s12028-020-00949-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Tia Chakraborty
- Mayo Clinic Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
| | - Eelco Wijdicks
- Mayo Clinic Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
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3
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Pan P, Bai L, Hua X, Wang Y, Jiang X, Cheng X, Song Y, Yu X. miR-155 Regulates claudin1 Expression in Humans With Intestinal Mucosa Dysfunction After Brain Injury. Transplant Proc 2020; 51:3474-3480. [PMID: 31810510 DOI: 10.1016/j.transproceed.2019.08.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/24/2019] [Accepted: 08/30/2019] [Indexed: 02/06/2023]
Abstract
Patients with craniocerebral trauma often have intestinal mucosal dysfunction, and the claudin1 protein plays an important role in intestinal mucosal function. Our previous work has shown that the expression of microRNA-155 (miR-155) in the peripheral blood of patients with craniocerebral trauma is decreased. Animal experiments also suggest that the expression of miR-155 is increased in the intestinal mucosa of mice with brain injury and the expression of claudin1 is decreased. We recruited 56 samples (35 patients with traumatic brain injury [TBI] and 21 patients without history of head trauma) to detect the expression of miR-155 on claudin1 regulation by quantitative polymerase chain reaction, reverse transcriptase polymerase chain reaction, and so on. We also used the receiver operating characteristic curve (ROC) to further evaluate the diagnostic value of the 2 biomarkers. From the results, we found that the expression level of miR-155 and claudin1 in the case group was lower than that in the control group. Human miR-155 (Hsa-miR-155) may positively regulate intestinal mucosal function by inhibiting the expression of claudin1, leading to intestinal mucosal barrier dysfunction. Combining the ROC curve data, the results further prove that miR-155 and claudin1 might be the new clinical diagnostic markers and treatment targets for the intestinal mucosal barrier dysfunction after TBI.
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Affiliation(s)
- Pengfei Pan
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Linlin Bai
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Xiaoli Hua
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Yuqiang Wang
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Xiaofang Jiang
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Xi Cheng
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Yunlin Song
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
| | - Xiangyou Yu
- Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
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Royes LFF, Gomez-Pinilla F. Making sense of gut feelings in the traumatic brain injury pathogenesis. Neurosci Biobehav Rev 2019; 102:345-361. [PMID: 31102601 DOI: 10.1016/j.neubiorev.2019.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) is a devastating condition which often initiates a sequel of neurological disorders that can last throughout lifespan. From metabolic perspective, TBI also compromises systemic physiology including the function of body organs with subsequent malfunctions in metabolism. The emerging panorama is that the effects of TBI on the periphery strike back on the brain and exacerbate the overall TBI pathogenesis. An increasing number of clinical reports are alarming to show that metabolic dysfunction is associated with incidence of long-term neurological and psychiatric disorders. The autonomic nervous system, associated hypothalamic-pituitary axis, and the immune system are at the center of the interface between brain and body and are central to the regulation of overall homeostasis and disease. We review the strong association between mechanisms that regulate cell metabolism and inflammation which has important clinical implications for the communication between body and brain. We also discuss the integrative actions of lifestyle interventions such as diet and exercise on promoting brain and body health and cognition after TBI.
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Affiliation(s)
- Luiz Fernando Freire Royes
- Exercise Biochemistry Laboratory, Center of Physical Education and Sports, Federal University of Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Fernando Gomez-Pinilla
- Departments of Neurosurgery, and Integrative and Biology and Physiology, UCLA Brain Injury Research Center, University of California, Los Angeles, USA.
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5
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Perouansky M. In Response. Anesth Analg 2018; 127:e92-e93. [PMID: 30234541 DOI: 10.1213/ane.0000000000003769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Misha Perouansky
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
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6
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Nutritional and Bioenergetic Considerations in Critically Ill Patients with Acute Neurological Injury. Neurocrit Care 2018; 27:276-286. [PMID: 28004327 DOI: 10.1007/s12028-016-0336-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed. However, there are no such specific guidelines for the critically ill patient with neurological injury. Patients with primary or secondary neurological disorders are frequently undernourished, while data suggest this population would benefit from early and adequate nutritional support, although comprehensive clinical evidence is lacking. We review the joint recommendations from the Society for Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition, as they pertain to neurocritical care, and assess the recommendations for addressing nutrition in this patient population.
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Abstract
Traumatic brain injury (TBI) is a complex disorder that affects millions of people worldwide. The complexity of TBI partly stems from the fact that injuries to the brain instigate non-neurological injuries to other organs such as the intestine. Additionally, genetic variation is thought to play a large role in determining the nature and severity of non-neurological injuries. We recently reported that TBI in flies, as in humans, increases permeability of the intestinal epithelial barrier resulting in hyperglycemia and a higher risk of death. Furthermore, we demonstrated that genetic variation in flies is also pertinent to the complexity of non-neurological injuries following TBI. The goals of this review are to place our findings in the context of what is known about TBI-induced intestinal permeability from studies of TBI patients and rodent TBI models and to draw attention to how studies of the fly TBI model can provide unique insights that may facilitate diagnosis and treatment of TBI.
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Affiliation(s)
| | - Barry Ganetzky
- a Laboratory of Genetics; University of Wisconsin-Madison ; Madison , WI USA
| | - David A Wassarman
- a Laboratory of Genetics; University of Wisconsin-Madison ; Madison , WI USA
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Schulze J, Vogelgesang A, Dressel A. Catecholamines, steroids and immune alterations in ischemic stroke and other acute diseases. Aging Dis 2014; 5:327-39. [PMID: 25276491 DOI: 10.14336/ad.2014.0500327] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 05/09/2014] [Accepted: 05/27/2014] [Indexed: 11/01/2022] Open
Abstract
The outcome of stroke patients is not only determined by the extent and localization of the ischemic lesion, but also by stroke-associated infections. Stroke-induced immune alterations, which are related to stroke-associated infections, have been described over the last decade. Here we review the evidence that catecholamines and steroids induced by stroke result in stroke-induced immune alterations. In addition, we compare the immune alterations observed in other acute diseases such as myocardial infarction, brain trauma, and surgical trauma with the changes seen in stroke-induced immune alterations.
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Affiliation(s)
| | - Antje Vogelgesang
- Section of Neuroimmunology, Department of Neurology, University Medicine Greifswald, Germany
| | - Alexander Dressel
- Section of Neuroimmunology, Department of Neurology, University Medicine Greifswald, Germany
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Catania A, Lonati C, Sordi A, Gatti S. Detrimental consequences of brain injury on peripheral cells. Brain Behav Immun 2009; 23:877-84. [PMID: 19394418 DOI: 10.1016/j.bbi.2009.04.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/12/2009] [Accepted: 04/14/2009] [Indexed: 11/18/2022] Open
Abstract
Acute brain injury and brain death exert detrimental effects on peripheral host cells. Brain-induced impairment of immune function makes patients more vulnerable to infections that are a major cause of morbidity and mortality after stroke, trauma, or subarachnoid hemorrhage (SAH). Systemic inflammation and organ dysfunction are other harmful consequences of CNS injury. Brain death, the most severe consequence of brain injury, causes inflammatory changes in peripheral organs that can contribute to the inferior outcome of organs transplanted from brain-dead donors. Understanding of the mechanisms underlying the detrimental effects of brain injury on peripheral organs remains incomplete. However, it appears that sympathetic nervous system (SNS)-activation contributes to elicit both inflammation and immunodepression. Indeed, norepinephrine (NE)-induced production of chemokines in liver and other organs likely participates in local and systemic inflammatory changes. Conversely, catecholamine-stimulated interleukin-10 (IL-10) production by blood monocytes exerts immunosuppressive effects. Activation of the hypothalamic-pituitary-adrenal axis (HPA) by increased inflammatory cytokines within the brain is a significant component in the CNS-induced immune function inhibition. Non-neurologic consequences of brain injury show impressive similarities regardless of the brain insult and appear to depend on altered neuroimmune circuits. Modulation of these circuits could reduce extra-brain damage and improve patient outcome in both vascular and traumatic brain injury.
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Affiliation(s)
- Anna Catania
- Center for Preclinical Investigation, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano, Italy.
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