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Chen Y, Pang J, Chen Y, Liang Y, Zhang Z, Wang Z. Diallyl trisulfide regulates PGK1/Nrf2 expression and reduces inflammation to alleviate neurological damage in mice after traumatic brain injury. Brain Res 2024; 1843:149116. [PMID: 38977238 DOI: 10.1016/j.brainres.2024.149116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/07/2024] [Accepted: 07/05/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Diallyl trisulfide (DATS) has a direct antioxidant capacity and emerges as a promising neuroprotective agent. This study was designed to investigate the role of DATS in traumatic brain injury (TBI). METHODS TBI mouse models were established using the controlled cortical impact, followed by DATS administration. The effects of DATS on neurological deficit, brain damage, inflammation and phosphoglycerate kinase 1 (PGK1) expression were detected using mNSS test, histological analysis, TUNEL assay, enzyme-linked immunosorbent assay and immunofluorescence. PC12 cells were subjected to H2O2-induced oxidative injury after pre-treatment with DATS, followed by cell counting kit-8 assay, flow cytometry and ROS production detection. Apoptosis-related proteins and the PGK1/nuclear factor erythroid-2 related factor 2 (Nrf2) pathway were examined using Western blot. RESULTS DATS ameliorated the cerebral cortex damage, neurological dysfunction and apoptosis, as well as decreased PGK1 expression and expressions of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α) in mice after TBI. DATS also enhanced viability, blocked apoptosis and inhibited ROS production in H2O2-induced PC12 cells. DATS downregulated Cleaved-Caspase3, Bax and PGK1 levels, and upregulated Bcl-2 and Nrf2 levels in TBI mouse models and the injured cells. CONCLUSION DATS regulates PGK1/Nrf2 expression and inflammation to alleviate neurological damage in mice after TBI.
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Affiliation(s)
- Yafei Chen
- Department of Laboratory Medicine, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), PR China
| | - Jianliang Pang
- Department of Vascular Surgery, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital) , PR China
| | - Yulong Chen
- Department of Laboratory Medicine, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), PR China
| | - Ying Liang
- Injection Room, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), PR China
| | - Zhengbo Zhang
- Department of Laboratory Medicine, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), PR China
| | - Zhangquan Wang
- Department of Laboratory Medicine, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), PR China.
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Zhang Z, Wu X, Kong Y, Zou P, Wang Y, Zhang H, Cui G, Zhu W, Chen H. Dynamic Changes and Effects of H 2S, IGF-1, and GH in the Traumatic Brain Injury. Biochem Genet 2024; 62:3821-3840. [PMID: 38233694 DOI: 10.1007/s10528-023-10557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/21/2023] [Indexed: 01/19/2024]
Abstract
The aim of this study was to examine the expression changes of H2S, IGF-1, and GH in traumatic brain injury (TBI) patients and to detect their neuroprotective functions after TBI. In this study, we first collected cerebrospinal fluid (CSF) and plasma from TBI patients at different times after injury and evaluated the concentrations of H2S, IGF-1, and GH. In vitro studies were using the scratch-induced injury model and cell-cell interaction model (HT22 hippocampal neurons co-cultured with LPS-induced BV2 microglia cells). In vivo studies were using the controlled cortical impact (CCI) model in mice. Cell viability was assessed by CCK-8 assay. Pro-inflammatory cytokines expression was determined by qRT-PCR, ELISA, and nitric oxide production. Western blot was performed to assess the expression of CBS, CSE, IGF-1, and GHRH. Moreover, the recovery of TBI mice was evaluated for behavioral function by applying the modified Neurological Severity Score (mNSS), the Rotarod test, and the Morris water maze. We discovered that serum H2S, CSF H2S, and serum IGF-1 concentrations were all adversely associated with the severity of the TBI, while the concentrations of IGF-1 and GH in CSF and GH in the serum were all positively related to TBI severity. Experiments in vitro and in vivo indicated that treatment with NaHS (H2S donor), IGF-1, and MR-409 (GHRH agonist) showed protective effects after TBI. This study gives novel information on the functions of H2S, IGF-1, and GH in TBI.
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Affiliation(s)
- Zhen Zhang
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Xin Wu
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Yang Kong
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Peng Zou
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Yanbin Wang
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Hongtao Zhang
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Guangqiang Cui
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China
| | - Wei Zhu
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China.
| | - Hongguang Chen
- Department of Neurosurgery, Yantai Yuhuangding Hospital, Yuhuangding East Road, Zhifu District, 264000, Yantai, Shandong, China.
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Giesler LP, Mychasiuk R, Shultz SR, McDonald SJ. BDNF: New Views of an Old Player in Traumatic Brain Injury. Neuroscientist 2024; 30:560-573. [PMID: 37067029 PMCID: PMC11423547 DOI: 10.1177/10738584231164918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Traumatic brain injury is a common health problem affecting millions of people each year. BDNF has been investigated in the context of traumatic brain injury due to its crucial role in maintaining brain homeostasis. Val66Met is a functional single-nucleotide polymorphism that results in a valine-to-methionine amino acid substitution at codon 66 in the BDNF prodomain, which ultimately reduces secretion of BDNF. Here, we review experimental animal models as well as clinical studies investigating the role of the Val66Met single-nucleotide polymorphism in traumatic brain injury outcomes, including cognitive function, motor function, neuropsychiatric symptoms, and nociception. We also review studies investigating the role of BDNF on traumatic brain injury pathophysiology as well as circulating BDNF as a biomarker of traumatic brain injury.
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Affiliation(s)
| | - Richelle Mychasiuk
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, The Alfred Hospital, Melbourne, Australia
| | - Sandy R. Shultz
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, The Alfred Hospital, Melbourne, Australia
| | - Stuart J. McDonald
- Department of Neuroscience, Monash University, Melbourne, Australia
- Department of Neurology, The Alfred Hospital, Melbourne, Australia
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Săcărescu A, Turliuc MD. Electrolyte Imbalance in Acute Traumatic Brain Injury: Insights from the First 24 h. Clin Pract 2024; 14:1767-1778. [PMID: 39311291 PMCID: PMC11417862 DOI: 10.3390/clinpract14050141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/25/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND/OBJECTIVES Electrolyte disturbances are common in patients with traumatic brain injury (TBI), particularly affecting sodium, potassium, chloride, and calcium levels. This study aims to provide insights into these disturbances within the first 24 h post-injury. METHODS We conducted a cross-sectional analysis of 50 TBI patients, excluding those with conditions affecting electrolyte balance. Electrolyte levels were measured, and correlations with demographic data, trauma mechanisms, imaging findings, and Glasgow Coma Scale (GCS) scores were analyzed. RESULTS The results indicated that chloride levels inversely correlated with GCS scores (ρ = -0.515; p = 0.002), suggesting that elevated chloride may indicate severe neurological impairment. Potassium levels were significantly associated with subdural hematoma (p = 0.032) and subarachnoid hemorrhage (p = 0.043), highlighting their potential as markers for severe brain injuries. No significant associations were found between sodium or calcium levels and the studied variables. CONCLUSIONS These findings underscore the importance of early monitoring of chloride and potassium levels in TBI patients to improve management and outcomes. Future research should focus on larger, multi-center studies to validate these findings and develop comprehensive guidelines for managing electrolyte imbalances in TBI patients.
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Affiliation(s)
- Alina Săcărescu
- Department of Medical Specialties III, “Grigore T. Popa” University of Medicine and Pharmacy, Universității 16, 700115 Iași, Romania
- Department of Neurology, Clinical Rehabilitation Hospital, Pantelimon Halipa 14, 700661 Iași, Romania
| | - Mihaela-Dana Turliuc
- Department of Surgery II, “Grigore T. Popa” University of Medicine and Pharmacy, Universitătii 16, 700115 Iași, Romania;
- Department of Neurosurgery I, “Prof. Dr. N. Oblu” Clinical Emergency Hospital, Ateneului 2, 700309 Iași, Romania
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Dudek E, Williams MW, Kew CLN, DeMello A, Wright B, Holland AB, Day-Gorman A, Gonzalez AS, Leon Novelo L, Liu X, Juengst SB. A Directed Content Analysis for Greatest Problems Among People With and Without Traumatic Brain Injury. Arch Phys Med Rehabil 2024:S0003-9993(24)01186-9. [PMID: 39187005 DOI: 10.1016/j.apmr.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions. DESIGN A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4. SETTING Community. PARTICIPANTS A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Open-text responses to the survey prompt: "What was your greatest problem or need over the past 2 weeks?" RESULTS The Participation index comprised the greatest proportion of responses across all 4 participant groups. A quarter (25.4%) of controls reported None (no problem/need), whereas only 7.9%-10.7% of participants in all other groups reported None. Among all groups, individuals with TBI reported the greatest proportion of problems in the Adjustment and Ability indices. Among people with TBI, Money Management (19.7%), None (10.6%), and Anxiety (7.7%) were the 3 most frequently reported problems. Compared with individuals with mild TBI (mTBI), individuals with moderate-to-severe TBI (msTBI) reported a higher proportion of problems in the Ability and Adjustment indices. Among individuals with msTBI, the Adjustment index accounted for the greatest proportion of problems. CONCLUSIONS This study employed a person-centered approach to understanding the greatest needs among individuals with TBI. Qualitative differences were observed between individuals with and without TBI, between people with mTBI and msTBI, and across genders among people with TBI. These findings can help guide research and policy toward addressing challenges perceived as highly important by people living in the community with TBI.
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Affiliation(s)
- Emily Dudek
- Department of Psychology, University of Houston, Houston
| | | | - Chung Lin Novelle Kew
- Department of Health Behavior Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station
| | - Annalyn DeMello
- School of Nursing, The University of Texas Medical Branch, Galveston
| | - Brittany Wright
- Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas
| | - Alexandra B Holland
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston
| | | | | | - Luis Leon Novelo
- Department of Data Science, University of Texas Health Sciences Center at Houston, Houston
| | - Xiangyi Liu
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston
| | - Shannon B Juengst
- Department of Physical Medicine & Rehabilitation, UT Southwestern Medical Center, Dallas; Brain Injury Research Center, TIRR Memorial Hermann, Houston; Department of Physical Medicine & Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, TX
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Ma Z, He Z, Li Z, Gong R, Hui J, Weng W, Wu X, Yang C, Jiang J, Xie L, Feng J. Traumatic brain injury in elderly population: A global systematic review and meta-analysis of in-hospital mortality and risk factors among 2.22 million individuals. Ageing Res Rev 2024; 99:102376. [PMID: 38972601 DOI: 10.1016/j.arr.2024.102376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) among elderly individuals poses a significant global health concern due to the increasing ageing population. METHODS We searched PubMed, Cochrane Library, and Embase from database inception to Feb 1, 2024. Studies performed in inpatient settings reporting in-hospital mortality of elderly people (≥60 years) with TBI and/or identifying risk factors predictive of such outcomes, were included. Data were extracted from published reports, in-hospital mortality as our main outcome was synthesized in the form of rates, and risk factors predicting in-hospital mortality was synthesized in the form of odds ratios. Subgroup analyses, meta-regression and dose-response meta-analysis were used in our analyses. FINDINGS We included 105 studies covering 2217,964 patients from 30 countries/regions. The overall in-hospital mortality of elderly patients with TBI was 16 % (95 % CI 15 %-17 %) from 70 studies. In-hospital mortality was 5 % (95 % CI, 3 %-7 %), 18 % (95 % CI, 12 %-24 %), 65 % (95 % CI, 59 %-70 %) for mild, moderate and severe subgroups from 10, 7, and 23 studies, respectively. A decrease in in-hospital mortality over years was observed in overall (1981-2022) and in severe (1986-2022) elderly patients with TBI. Older age 1.69 (95 % CI, 1.58-1.82, P < 0.001), male gender 1.34 (95 % CI, 1.25-1.42, P < 0.001), clinical conditions including traffic-related cause of injury 1.22 (95 % CI, 1.02-1.45, P = 0.029), GCS moderate (GCS 9-12 compared to GCS 13-15) 4.33 (95 % CI, 3.13-5.99, P < 0.001), GCS severe (GCS 3-8 compared to GCS 13-15) 23.09 (95 % CI, 13.80-38.63, P < 0.001), abnormal pupillary light reflex 3.22 (95 % CI, 2.09-4.96, P < 0.001), hypotension after injury 2.88 (95 % CI, 1.06-7.81, P = 0.038), polytrauma 2.31 (95 % CI, 2.03-2.62, P < 0.001), surgical intervention 2.21 (95 % CI, 1.22-4.01, P = 0.009), pre-injury health conditions including pre-injury comorbidity 1.52 (95 % CI, 1.24-1.86, P = 0.0020), and pre-injury anti-thrombotic therapy 1.51 (95 % CI, 1.23-1.84, P < 0.001) were related to higher in-hospital mortality in elderly patients with TBI. Subgroup analyses according to multiple types of anti-thrombotic drugs with at least two included studies showed that anticoagulant therapy 1.70 (95 % CI, 1.04-2.76, P = 0.032), Warfarin 2.26 (95 % CI, 2.05-2.51, P < 0.001), DOACs 1.99 (95 % CI, 1.43-2.76, P < 0.001) were related to elevated mortality. Dose-response meta-analysis of age found an odds ratio of 1.029 (95 % CI, 1.024-1.034, P < 0.001) for every 1-year increase in age on in-hospital mortality. CONCLUSIONS In the field of elderly patients with TBI, the overall in-hospital mortality and its temporal-spatial feature, the subgroup in-hospital mortalities according to injury severity, and dose-response meta-analysis of age were firstly comprehensively summarized. Substantial key risk factors, including the ones previously not elucidated, were identified. Our study is thus of help in underlining the importance of treating elderly TBI, providing useful information for healthcare providers, and initiating future management guidelines. This work underscores the necessity of integrating elderly TBI treatment and management into broader health strategies to address the challenges posed by the aging global population. REVIEW REGISTRATION PROSPERO CRD42022323231.
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Affiliation(s)
- Zixuan Ma
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Zhenghui He
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Zhifan Li
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Ru Gong
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Jiyuan Hui
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Weiji Weng
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Xiang Wu
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Chun Yang
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Jiyao Jiang
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Li Xie
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Junfeng Feng
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Shanghai Institute of Head Trauma, Shanghai 200127, China.
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Omar S, Williams CC, Bugg LB, Colantonio A. "If you do not have Black futures in mind…then what's guiding the steps": anti-racist recommendations for traumatic brain injury rehabilitations' investments in hopeful Black futures. Disabil Rehabil 2024:1-20. [PMID: 39089328 DOI: 10.1080/09638288.2024.2367604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 08/03/2024]
Abstract
PURPOSE The need for specialized rehabilitation considerations to address racial health disparities and optimize functional outcomes such as participation in daily life for Black people with traumatic brain injury (TBI) has been acknowledged. This study uses anti-racism as an entry point for addressing institutional racism by examining what the experiences of Black survivors of TBI, rehabilitation providers, and family caregivers tell us about imagined possibilities for rehabilitation to promote Black futures. MATERIAL AND METHODS A constructivist-informed narrative inquiry using critical race theory and in-depth narrative interviewing was applied across ten women and four men. Reflexive thematic analysis within and across groups of participants led to conceptualizing two main themes and five sub-themes. RESULTS Conceptualized themes captured requirements for TBI rehabilitations' investments in Black futures: (1) the need for critical information and specialized educational supports and particular requirements for supporting participation in meaningful life situations, and (2) responsibilities of delivering rehabilitation care for Black service users. CONCLUSION TBI rehabilitation must be tailored to the realities of living while being Black, integrate personal values, beliefs, interests, and equitable supports to maximize optimal functioning and participation if the goal of rehabilitation is community integration for all persons living with the impacts of TBI.
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Affiliation(s)
- Samira Omar
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Laura Beth Bugg
- Global and Community Health, University of CA Santa Cruz, CA, USA
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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Alashram AR. Semont maneuver for posterior canal benign paroxysmal positional vertigo: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024; 281:3985-3999. [PMID: 38530461 DOI: 10.1007/s00405-024-08586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This review aimed to examine the effects of the Semont maneuver on posterior canal benign paroxysmal positional vertigo (BPPV). METHODS PubMed, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched comprehensively from inception to January 2024. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate the quality of the selected studies. RESULTS In total, 18 randomized controlled trials met the eligibility criteria. A total of 2237 participants with BPPV (mean age = 58.10 years) were included in this review. Among them, 37.5% were males, and 58% presented with right-sided BPPV. The included studies ranked from 5 to 9 out of 10 (Median = 7), suggesting good to excellent quality on the PEDro scale. The available literature revealed that the Semont maneuver is effective in improving posterior canal BPPV symptoms. CONCLUSION The Semont maneuver is considered a standard option for treating posterior canal BPPV, with a high success rate of around 80%. It is suggested as the primary option for managing posterior canal BPPV in individuals who complain of cervical or lumbar problems, severe cardiac or respiratory conditions. Further studies are strongly needed to understand the long-term effects of the Semont maneuver and to identify the recurrence rate.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road 1666, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
- Centre of SpaceBio-Medicine, Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", 00133, Rome, Italy.
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Sant’Ana TT, Hanafy S, Fuller-Thomson E, McDonald M, Colantonio A, Cee D, McGettrick G, Lawlor B, Mollayeva T. A PROGRESS-driven approach to cognitive outcomes after traumatic brain injury: A study protocol for advancing equity, diversity, and inclusion through knowledge synthesis and mobilization. PLoS One 2024; 19:e0307418. [PMID: 39037993 PMCID: PMC11262676 DOI: 10.1371/journal.pone.0307418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/24/2024] Open
Abstract
Evidence syntheses for advancing equitable traumatic brain injury (TBI) research, policy, and practice presents formidable challenges. Research and clinical frameworks are currently not specific to equity, diversity, and inclusion considerations, despite evidence that persons with TBI live in societies in which power imbalances and systems of social dominance may privilege some people and marginalize others. The present protocol outlines a strategy for a research program, supported by the Canadian Institutes of Health Research, that explores the integration of PROGRESS-Plus parameters in research with the goal of advancing open-science databases and tools to improve our understanding of equity in cognitive and brain health outcomes in TBI. PROGRESS-Plus is a framework outlining social, economic, and cultural parameters that may influence health opportunities and outcomes (e.g., place of residence, race, occupation, gender, etc.). A multistep research program is proposed to support three objectives: (1) organizing existing data on TBI-induced changes in cognition and brain health into a template to facilitate future research, including research using machine learning techniques; (2) updating published evidence with a more rigorous approach to the consideration of PROGRESS-Plus parameters; and (3) mobilizing knowledge on the current state of evidence that is relevant, equitable, and accessible. This program facilitates partnerships with knowledge users across clinical, research, academic, and community sectors to address the three research objectives through a unifying workflow of exchange, synthesis, and knowledge mobilization. We anticipate that this global collaboration between topic experts and community leaders in equity in brain health will add significant value to the field of TBI by promoting equity-transformative advancements in knowledge synthesis, policy, and practice.
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Affiliation(s)
- Thaisa Tylinski Sant’Ana
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Sara Hanafy
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Esme Fuller-Thomson
- Institute for Life Course & Aging, University of Toronto, Toronto, Ontario, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Department of Family & Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Angela Colantonio
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Daìthì Cee
- Flemish Dementia Working Group, Publications Department, Aalter, East Flanders, Belgium
| | - Gráinne McGettrick
- Global Brain Health Institute, University of California San Francisco, San Francisco, Francisco, California, United States of America
- Acquired Brain Injury Ireland, Dublin, Leinster, Ireland
| | - Brian Lawlor
- Global Brain Health Institute, University of California San Francisco, San Francisco, Francisco, California, United States of America
- Trinity College Dublin, University of Dublin, Dublin, Leinster, Ireland
| | - Tatyana Mollayeva
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, University of Toronto, Toronto, Ontario, Canada
- Global Brain Health Institute, University of California San Francisco, San Francisco, Francisco, California, United States of America
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10
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Guida F, Iannotta M, Lauritano A, Infantino R, Salviati E, Verde R, Luongo L, Sommella EM, Iannotti FA, Campiglia P, Maione S, Di Marzo V, Piscitelli F. Early biomarkers in the presymptomatic phase of cognitive impairment: changes in the endocannabinoidome and serotonergic pathways in Alzheimer's-prone mice after mTBI. Acta Neuropathol Commun 2024; 12:113. [PMID: 38992700 PMCID: PMC11241935 DOI: 10.1186/s40478-024-01820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Despite extensive studies on the neurobiological correlates of traumatic brain injury (TBI), little is known about its molecular determinants on long-term consequences, such as dementia and Alzheimer's disease (AD). METHODS Here, we carried out behavioural studies and an extensive biomolecular analysis, including inflammatory cytokines, gene expression and the combination of LC-HRMS and MALDI-MS Imaging to elucidate the targeted metabolomics and lipidomics spatiotemporal alterations of brains from wild-type and APP-SWE mice, a genetic model of AD, at the presymptomatic stage, subjected to mild TBI. RESULTS We found that brain injury does not affect cognitive performance in APP-SWE mice. However, we detected an increase of key hallmarks of AD, including Aβ1-42 levels and BACE1 expression, in the cortices of traumatized transgenic mice. Moreover, significant changes in the expanded endocannabinoid (eCB) system, or endocannabinoidome (eCBome), occurred, including increased levels of the endocannabinoid 2-AG in APP-SWE mice in both the cortex and hippocampus, and N-acylserotonins, detected for the first time in the brain. The gene expression of enzymes for the biosynthesis and inactivation of eCBs and eCB-like mediators, and some of their main molecular targets, also underwent significant changes. We also identified the formation of heteromers between cannabinoid 1 (CB1) and serotonergic 2A (5HT2A) receptors, whose levels increased in the cortex of APP-SWE mTBI mice, possibly contributing to the exacerbated pathophysiology of AD induced by the trauma. CONCLUSIONS Mild TBI induces biochemical changes in AD genetically predisposed mice and the eCBome may play a role in the pathogenetic link between brain injury and neurodegenerative disorders also by interacting with the serotonergic system.
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Affiliation(s)
- Francesca Guida
- Pharmacology Division, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Monica Iannotta
- Pharmacology Division, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Anna Lauritano
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Pozzuoli, (NA), Italy
| | - Rosmara Infantino
- Pharmacology Division, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Emanuela Salviati
- Dipartimento di Farmacia, Università Degli Studi di Salerno, Fisciano, (SA), Italy
| | - Roberta Verde
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Pozzuoli, (NA), Italy
| | - Livio Luongo
- Pharmacology Division, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Fabio Arturo Iannotti
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Pozzuoli, (NA), Italy
| | - Pietro Campiglia
- Dipartimento di Farmacia, Università Degli Studi di Salerno, Fisciano, (SA), Italy
| | - Sabatino Maione
- Pharmacology Division, Department of Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vincenzo Di Marzo
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Pozzuoli, (NA), Italy.
- Institut Universitaire de Cardiologie et de Pneumologie de Québec and Institut sur la Nutrition et les Aliments Fonctionnels, Centre NUTRISS, Université Laval, Quebec City, Canada.
| | - Fabiana Piscitelli
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry (ICB), National Research Council (CNR), Pozzuoli, (NA), Italy.
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11
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Alashram AR. Effectiveness of brandt-daroff exercises in the treatment of benign paroxysmal positional vertigo: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024; 281:3371-3384. [PMID: 38341824 DOI: 10.1007/s00405-024-08502-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE This review aims to examine the effects of Brandt-Daroff exercises (BDEs) on individuals with posterior canal Benign Paroxysmal Positional Vertigo (BPPV) and to provide recommendations for future research on this topic. METHODS PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. RESULTS In total, ten randomized controlled trials met our eligibility criteria. A total of 880 individuals with BPPV (63.6% females) were included in this review. The included studies were ranked "good quality" on the PEDro scale. The available literature showed that BDEs do not significantly reduce symptoms or promote recovery in people with posterior canal BPPV compared to other interventions, such as Epley and Semont maneuvers. CONCLUSIONS The evidence for the effects of BDEs on patients with BPPV is limited. Further high-quality studies with long-term follow-ups are strongly required to investigate the long-term effects of BDEs in posterior canal BPPV, define the optimal application of BDEs, and identify the factors associated with treatment response and recovery.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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12
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Ozturk ED, Zhang Y, Lai MHC, Sakamoto MS, Chanfreau-Coffinier C, Merritt VC. Measurement Invariance of the Neurobehavioral Symptom Inventory in Male and Female Million Veteran Program Enrollees Completing the Comprehensive Traumatic Brain Injury Evaluation. Assessment 2024; 31:967-979. [PMID: 37710416 DOI: 10.1177/10731911231198214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This study evaluated measurement invariance across males and females on the Neurobehavioral Symptom Inventory (NSI) in U.S. military veterans enrolled in the VA Million Veteran Program. Participants (N = 17,059; males: n = 15,450; females: n = 1,609) included Veterans who took part in the VA Traumatic Brain Injury (TBI) Screening and Evaluation Program and completed the NSI. Multiple-group confirmatory factor analyses investigated measurement invariance of the NSI 4-factor model. The configural (comparative fit index [CFI] = 0.948, root mean square error of approximation [RMSEA] = 0.060) and metric (CFI = 0.948, RMSEA = 0.058) invariance models showed acceptable fit. There was a minor violation of scalar invariance (Δχ2 = 232.50, p < .001); however, the degree of noninvariance was mild (ΔCFI = -0.002, Δ RMSEA = 0 . 000 ). Our results demonstrate measurement invariance across sex, suggesting that the NSI 4-factor model can be used to accurately assess symptoms in males and females following TBI. Findings highlight the importance of considering validity of measurement across study groups to increase confidence that a measure is interpreted similarly by respondents from different subgroups.
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Affiliation(s)
- Erin D Ozturk
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- San Diego State University and University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Yichi Zhang
- University of Southern California, Los Angeles, CA, USA
| | - Mark H C Lai
- University of Southern California, Los Angeles, CA, USA
| | - McKenna S Sakamoto
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Penn State University, University Park, PA, USA
| | | | - Victoria C Merritt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- University of California San Diego, La Jolla, CA, USA
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13
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Zhang N, Zhang S, Dong X. Plant-derived bioactive compounds and their novel role in central nervous system disorder treatment via ATF4 targeting: A systematic literature review. Biomed Pharmacother 2024; 176:116811. [PMID: 38795641 DOI: 10.1016/j.biopha.2024.116811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
Central nervous system (CNS) disorders exhibit exceedingly intricate pathogenic mechanisms. Pragmatic and effective solutions remain elusive, significantly compromising human life and health. Activating transcription factor 4 (ATF4) participates in the regulation of multiple pathophysiological processes, including CNS disorders. Considering the widespread involvement of ATF4 in the pathological process of CNS disorders, the targeted regulation of ATF4 by plant-derived bioactive compounds (PDBCs) may become a viable strategy for the treatment of CNS disorders. However, the regulatory relationship between PDBCs and ATF4 remains incompletely understood. Here, we aimed to comprehensively review the studies on PDBCs targeting ATF4 to ameliorate CNS disorders, thereby offering novel directions and insights for the treatment of CNS disorders. A computerized search was conducted on PubMed, Embase, Web of Science, and Google Scholar databases to identify preclinical experiments related to PDBCs targeting ATF4 for the treatment of CNS disorders. The search timeframe was from the inception of the databases to December 2023. Two assessors conducted searches using the keywords "ATF4," "Central Nervous System," "Neurological," "Alzheimer's disease," "Parkinson's Disease," "Stroke," "Spinal Cord Injury," "Glioblastoma," "Traumatic Brain Injury," and "Spinal Cord Injury." Overall, 31 studies were included, encompassing assessments of 27 PDBCs. Combining results from in vivo and in vitro studies, we observed that these PDBCs, via ATF4 modulation, prevent the deposition of amyloid-like fibers such as Aβ, tau, and α-synuclein. They regulate ERS, reduce the release of inflammatory factors, restore mitochondrial membrane integrity to prevent oxidative stress, regulate synaptic plasticity, modulate autophagy, and engage anti-apoptotic mechanisms. Consequently, they exert neuroprotective effects in CNS disorders. Numerous PDBCs targeting ATF4 have shown potential in facilitating the restoration of CNS functionality, thereby presenting expansive prospects for the treatment of such disorders. However, future endeavors necessitate high-quality, large-scale, and comprehensive preclinical and clinical studies to further validate this therapeutic potential.
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Affiliation(s)
- Nan Zhang
- Department of Neurology, the Seventh Clinical College of China Medical University, No. 24 Central Street, Xinfu District, Fushun, Liaoning 113000, China
| | - Shun Zhang
- Department of Neurology, Shengjing Hospital of China Medical University, No. 36 Sanhao street, Heping District, Shenyang, Liaoning 110000, China
| | - Xiaoyu Dong
- Department of Neurology, Shengjing Hospital of China Medical University, No. 36 Sanhao street, Heping District, Shenyang, Liaoning 110000, China.
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Omar S, Williams CC, Bugg LB, Colantonio A. Mapping the institutionalization of racism in the research about race and traumatic brain injury rehabilitation: implications for Black populations. Disabil Rehabil 2024:1-16. [PMID: 38950599 DOI: 10.1080/09638288.2024.2361803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/21/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE Traumatic brain injury (TBI) is a chronic disease process and a public health concern that disproportionately impacts Black populations. While there is an abundance of literature on race and TBI outcomes, there is a lack of scholarship that addresses racism within rehabilitation care, and it remains untheorized. This article aims to illuminate how racism becomes institutionalized in the scientific scholarship that can potentially inform rehabilitation care for persons with TBI and what the implications are, particularly for Black populations. MATERIAL AND METHODS Applying Bacchi's What's the Problem Represented to be approach, the writings of critical race theory (CRT) are used to examine the research about race and TBI rehabilitation comparable to CRT in other disciplines, including education and legal scholarship. RESULTS A CRT examination illustrates that racism is institutionalized in the research about race and TBI rehabilitation through colourblind ideologies, meritocracy, reinforcement of a deficit perspective, and intersections of race and the property functions of whiteness. A conceptual framework for understanding institutional racism in TBI rehabilitation scholarship is presented. CONCLUSIONS The findings from this article speak to the future of TBI rehabilitation research for Black populations, the potential for an anti-racist agenda, and implications for research and practice.
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Affiliation(s)
- Samira Omar
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Laura B Bugg
- Global and Community Health, University of CA Santa Cruz, Santa Cruz, CA, USA
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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15
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Khan SI, Karim R, Khan SI, Chowdhury MAK, Shill MC, Pasha FM, Shohag MH, Khan F, Islam MA, Mitul AI, Ahmad R, Hossain MS, Reza HM. Factors affecting severity and prognosis of traumatic brain injury among Bangladeshi patients: An institution based cross-sectional study. TRAFFIC INJURY PREVENTION 2024:1-9. [PMID: 38917382 DOI: 10.1080/15389588.2024.2363470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/29/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVE Traumatic brain injury (TBI) proves to be an obstacle for Bangladeshi patients due to the lack of facilities and specialist doctors in regional sections of the country. This study aimed to record different attributes of Bangladeshi TBI patients over a year i.e., their injury characteristics, treatments received and understand their impacts on the severity of TBI. METHOD This cross-sectional study was carried out among 280 TBI patients treated in a tertiary care hospital in Dhaka. The physicians determined TBI's severity and prognosis as per the Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS) respectively. RESULTS Most TBI patients were male (76.1%) and aged between 18 and 50 years (52.2%), as in previous studies in South Asian countries. However, the prevalence of TBI due to road traffic accidents (RTAs) was much higher (67.9%) than in the earlier studies in South Asia. Additionally, more patients suffered from severe TBI (29.3%) and moderate TBI (35.7%), and a higher percentage of patients went through surgery (56.8%) compared to previous studies. A significant association of demographic (residence) and clinical characteristics (consciousness after injury, CT scan findings and treatment type) with the severity of TBI was found in bivariate analysis. It also revealed the significant dependence of clinical characteristics (TBI etiology, post-injury consciousness, treatment type and TBI severity) on TBI prognosis. Multivariate analysis showed that patients who were unconscious after TBI and with evident brain injury observed in CT scans have a substantially higher risk of having moderate or severe TBI than mild TBI. Moreover, patients with TBI due to RTAs or falls, evident brain injury in CT scans, post-surgical seizure, and moderate or severe TBI have a significantly higher risk of getting a more unfavorable TBI prognosis than moderate disability. CONCLUSIONS In this study, RTAs were found to be the major cause of TBI. Additionally, some variables were identified as possible determinants of TBI severity and prognosis among Bangladeshi patients. The correlation of these variables with TBI should be further studied with the hopes that steps will be taken to reduce TBI incidents and improve its management to reduce the overall burden.
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Affiliation(s)
- Sabrin I Khan
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Reatul Karim
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Shahriar I Khan
- Department of Neurosurgery, Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh
| | | | - Manik C Shill
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Faisal M Pasha
- Department of Community Medicine and Public Health, Shaheed Monsur Ali Medical College, Dhaka, Bangladesh
| | - Md H Shohag
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Ferdous Khan
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Md A Islam
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Ariful I Mitul
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Reaz Ahmad
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Md S Hossain
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Hasan M Reza
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
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16
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Ma J, Li X, Wang X, Xin Z, Wang C. Association between Serum Magnesium Levels and Risk of Acute Kidney Injury in Patients with Traumatic Brain Injury: A Retrospective Cohort Study from the MIMIC-IV Database. Blood Purif 2024; 53:603-612. [PMID: 38838659 DOI: 10.1159/000539507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION The occurrence of acute kidney injury (AKI) is associated with a higher risk of mortality in patients with traumatic brain injury (TBI). This study aimed to explore the relationship between serum magnesium levels and the risk of AKI in patients with TBI. METHODS Patients with TBI were identified from the Medical Information Mart Intensive Care IV (MIMIC-IV) 2008-2019. The relationship between serum magnesium levels at admission and magnesium coefficient of variation (CV) during hospitalization and the risk of AKI was analyzed using multivariable logistic regression analysis and expressed as odds ratio (OR) and 95% confidence interval (CI). Subgroup analyses were performed according to Glasgow Coma Scale (GCS) score (<14, ≥14), sepsis (no, yes), and estimated glomerular filtration rate (eGFR; <60, ≥60). RESULTS Of the 991 patients included, 140 (14.13%) developed AKI during hospitalization. Patients with magnesium levels ≤1.7 mg/dL (tertile 1) (OR = 1.68, 95% CI: 1.01-2.81) were associated with a higher risk of AKI compared to those with magnesium levels of 1.7-2.0 mg/dL (tertile 2), but no association was found in those with magnesium levels >2.0 mg/dL (tertile 3) (p = 0.479). For magnesium CV, patients with magnesium CV >10% (tertile 3) (OR = 2.26, 95% CI: 1.16-4.41) were linked to an increased risk of AKI compared to those with magnesium CV ≤4% (tertile 1), but there may be a slight association between magnesium CV of 4%-10% (tertile 2) and AKI risk (OR = 1.86, 95% CI: 0.99-3.48; p = 0.053). Subgroup analyses showed that lower magnesium levels (≤1.7 mg/dL) or greater magnesium CV (>10%) were associated with a higher risk of AKI only in patients with a GCS score ≥14, non-sepsis, or eGFR ≥60 mL/min/1.73 m2 (p < 0.05). CONCLUSION Lower serum magnesium levels at admission or greater magnesium CV during hospitalization were associated with a higher risk of AKI in patients with TBI.
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Affiliation(s)
- Jinbang Ma
- Department of Neurosurgery, The Second People's Hospital of Liaocheng, Linqing, China
| | - Xiumin Li
- Department of Pediatric Internal Medicine, The Second People's Hospital of Liaocheng, Linqing, China
| | - Xinzhi Wang
- Department of Neurosurgery, The Second People's Hospital of Liaocheng, Linqing, China
| | - Zhenxue Xin
- Department of Neurosurgery, The Second People's Hospital of Liaocheng, Linqing, China
| | - Chuangang Wang
- Department of Neurosurgery, The Second People's Hospital of Liaocheng, Linqing, China
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17
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Armstrong-Javors A, Realbuto E, Dy-Hollins ME, Scharf JM. Increase in Functional Tic Presentations in Sexual Orientation and Gender Identity Minority Youth During Coronavirus Disease 2019. Pediatr Neurol 2024; 155:182-186. [PMID: 38677240 DOI: 10.1016/j.pediatrneurol.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/15/2024] [Accepted: 03/31/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Functional tic disorders are among the least common functional movement disorders, but their prevalence rose during the coronavirus disease 2019 (COVID-19) pandemic. Although female adolescents develop functional neurological disorders at higher rates than males, investigations into sexual orientation and gender identity (SOGI) status of these patients are limited. METHODS We completed a retrospective, cross-sectional time series examining the incidence of new-onset functional tic disorders in youth presenting to the Massachusetts General Hospital Movement Disorder clinics before and during the COVID-19 pandemic. Data were collected by searching for relevant International Classification of Diseases (ICD)-10 diagnostic codes in youth aged nine to 26 years using a hospital-wide data repository. Individual cases were reviewed for inclusion based on clinical criteria and expert consensus. RESULTS The prevalence of functional tic presentations in youth rose 8.6-fold from pre- to postpandemic levels (Fisher exact test P < 0.001), whereas the prevalence of developmental tic presentations pre- and postpandemic remained stable (114 vs 112). SOGI minority youth comprised 37% of those with functional tics (total n = 19). Ninety five percent of patients with functional tics identified as female, with 10% of these identifying as transgender. CONCLUSIONS Our data confirm previously demonstrated dramatic rises in functional tic presentations during the COVID-19 pandemic and, more notably, reveal a strong association with SOGI minority status. We highlight the potential link between functional tic disorders and SOGI minority status. Providing a safe and supportive clinical environment and addressing stress linked to SOGI minority status may help to improve patient prognosis.
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Affiliation(s)
| | - Evan Realbuto
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Department of Clinical Psychology, Kent State University, Kent, Ohio
| | | | - Jeremiah M Scharf
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
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18
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Poddar J, Rangasamy SB, Pahan K. Therapeutic efficacy of cinnamein, a component of balsam of Tolu/Peru, in controlled cortical impact mouse model of TBI. Neurochem Int 2024; 176:105742. [PMID: 38641028 DOI: 10.1016/j.neuint.2024.105742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
Traumatic brain injury (TBI) remains a major health concern which causes long-term neurological disability particularly in war veterans, athletes and young adults. In spite of intense clinical and research investigations, there is no effective therapy to cease the pathogenesis of the disease. It is believed that axonal injury during TBI is potentiated by neuroinflammation and demyelination and/or failure to remyelination. This study highlights the use of naturally available cinnamein, also chemically known as benzyl cinnamate, in inhibiting neuroinflammation, promoting remyelination and combating the disease process of controlled cortical impact (CCI)-induced TBI in mice. Oral delivery of cinnamein through gavage brought down the activation of microglia and astrocytes to decrease the expression of inducible nitric oxide synthase (iNOS), glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (Iba1) in hippocampus and cortex of TBI mice. Cinnamein treatment also stimulated remyelination in TBI mice as revealed by PLP and A2B5 double-labeling, luxol fast blue (LFB) staining and axonal double-labeling for neurofilament and MBP. Furthermore, oral cinnamein reduced the size of lesion cavity in the brain, improved locomotor functions and restored memory and learning in TBI mice. These results suggest a new neuroprotective property of cinnamein that may be valuable in the treatment of TBI.
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Affiliation(s)
- Jit Poddar
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Suresh B Rangasamy
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, 60612, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Kalipada Pahan
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, 60612, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA.
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D'Alonzo BA, Bretzin AC, Schneider AL, Morse RB, Canelón SP, Wiebe DJ, Boland MR. Comparison of different definitions of traumatic brain injury: implications for cohort characteristics and survival in women, Philadelphia, USA. Inj Prev 2024:ip-2023-045069. [PMID: 38802243 DOI: 10.1136/ip-2023-045069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/29/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Traumatic brain injury (TBI) is an acute injury that is understudied in civilian cohorts, especially among women, as TBI has historically been considered to be largely a condition of athletes and military service people. Both the Centres for Disease Control and Prevention (CDC) and Department of Defense (DOD)/Veterans Affairs (VA) have developed case definitions to identify patients with TBI from medical records; however, their definitions differ. We sought to re-examine these definitions to construct an expansive and more inclusive definition among a cohort of women with TBI. METHODS In this study, we use electronic health records (EHR) from a single healthcare system to study the impact of using different case definitions to identify patients with TBI. Specifically, we identified adult female patients with TBI using the CDC definition, DOD/VA definition and a combined and expanded definition herein called the Penn definition. RESULTS We identified 4446 adult-female TBI patients meeting the CDC definition, 3619 meeting the DOD/VA definition, and together, 6432 meeting our expanded Penn definition that includes the CDC ad DOD/VA definitions. CONCLUSIONS Using the expanded definition identified almost two times as many patients, enabling investigations to more fully characterise these patients and related outcomes. Our expanded TBI case definition is available to other researchers interested in employing EHRs to investigate TBI.
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Affiliation(s)
- Bernadette A D'Alonzo
- Department of Biostatistics Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Abigail C Bretzin
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrea Lc Schneider
- Department of Biostatistics Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rebecca B Morse
- Department of Biostatistics Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Silvia P Canelón
- Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Douglas J Wiebe
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mary Regina Boland
- Department of Mathematics, Saint Vincent College, Latrobe, Pennsylvania, USA
- Department of Marketing, Analytics and Global Commerce, Saint Vincent College, Latrobe, Pennsylvania, USA
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Rueda-García V, Rondón-Barragán IS. Molecular Characterization of Neurogranin (NRGN) Gene from Red‑Bellied Pacu (Piaractus brachypomus). Mol Neurobiol 2024; 61:2620-2630. [PMID: 37922064 PMCID: PMC11043121 DOI: 10.1007/s12035-023-03700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/06/2023] [Indexed: 11/05/2023]
Abstract
Neurogranin (NRGN) is a small brain protein expressed in various telencephalic areas and plays an essential role in synaptic plasticity by regulating the availability of calmodulin (CaM). The study aims to characterize the neurogranin gene in Colombian native fish, red-bellied pacu, Piaractus brachypomus, its basal tissue expression and differential expression in brain injury and sublethal toxicity by organophosphates. NRGN gene contains an open reading frame of 183 nucleotides encoding for 60 amino acids. Bioinformatics analysis showed an IQ motif necessary in the interaction with CaM. NRGN mRNA was detected in tissues with higher expression in brain, gills, and head kidney. In brain regions, NRGN showed high expression in the telencephalon (TE) and olfactory bulb (OB). In the sublethal toxicity experiment, NRGN mRNA was upregulated in individuals under organophosphate exposure in the OB and optic chiasm (OC). In brain injury experiment, NRGN showed upregulation at 14 days in OC and at 24 h and 7 days in TE. These findings demonstrate the differential expression of NRGN under different experimental conditions which make it a candidate for a biomarker in the brain of P. brachypomus.
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Affiliation(s)
- Valentina Rueda-García
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Building 33 L105, 730002, Ibagué, Tolima, Colombia
| | - Iang Schroniltgen Rondón-Barragán
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Building 33 L105, 730002, Ibagué, Tolima, Colombia.
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21
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Modak A, Zappi KE, Catoya AJ, Lemdani MS, Koller GM, Seltzer L, Radwanski RE, Pannullo SC. Sex Differences in Adult Incarceration After Pediatric Traumatic Brain Injury. Neurotrauma Rep 2024; 5:417-423. [PMID: 38655115 PMCID: PMC11035846 DOI: 10.1089/neur.2023.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Pediatric traumatic brain injury (pTBI) is a major risk factor associated with adulthood incarceration. Most research into the link between pTBI and adulthood incarceration has focused on incarcerated males, who comprise the vast majority of incarcerated adults, particularly in industrialized nations. In this review, we sought to identify sex-related differences in the incidence and pathophysiology of pTBI and subsequent risk of adulthood incarceration. A scoping review was undertaken using PubMed, Scopus, Ovid, and the Cochrane Library. Articles analyzing sex-related differences in pTBI and adult incarceration rates, studies conducted on an incarcerated population, and cohort studies, cross-sectional studies, clinical trials, systematic reviews, or meta-analyses were included in this review. Of the 85 unique results, 25 articles met our inclusion criteria. Male children are 1.5 times more likely to suffer a TBI than females; however, the prevalence of incarcerated adults with a history of pTBI is ∼35-45% for both sexes. Neurophysiologically, female sex hormones are implicated in neuroprotective roles, mitigating central nervous system (CNS) damage post-TBI, although this role may be more complex, given that injury severity and sequelae have been correlated with male sex whereas increased mortality has been correlated with female sex. Further investigation into the relationship between estrogen and subsequent clinical measurements of CNS function is needed to develop interventions that may alleviate the pathophysiological consequences of pTBI.
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Affiliation(s)
- Anurag Modak
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
- Brain and Spine Group, Bridgewater, New Jersey, USA
| | - Kyle E. Zappi
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
| | - Alexander J. Catoya
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
| | - Mehdi S. Lemdani
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
| | - Gretchen M. Koller
- Brain and Spine Group, Bridgewater, New Jersey, USA
- College of Medicine, Kansas City University, Kansas City, Missouri, USA
| | - Laurel Seltzer
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Ryan E. Radwanski
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
| | - Susan C. Pannullo
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
- Department of Biomedical Engineering, College of Engineering, Cornell University, New York, New York, USA
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22
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Sawant N, Watanabe A, Ueda H, Okano H, Morita M. Incomplete accumulation of perilesional reactive astrocytes exacerbates wound healing after closed-head injury by increasing inflammation and BBB disruption. Exp Neurol 2024; 374:114700. [PMID: 38272160 DOI: 10.1016/j.expneurol.2024.114700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024]
Abstract
Wound healing after closed-head injury is a significant medical issue. However, conventional models of focal traumatic brain injury, such as fluid percussion injury and controlled cortical impact, employ mechanical impacts on the exposed cerebral cortex after craniotomy. These animal models are inappropriate for studying gliosis, as craniotomy itself induces gliosis. To address this, we developed a closed-head injury model and named "photo injury", which employs intense light illumination through a thinned-skull cranial window. Our prior work demonstrated that the gliosis of focal cerebral lesion after the photo injury does not encompass artificial gliosis and comprises two distinct reactive astrocyte subpopulations. The reactive astrocytes accumulated in the perilesional recovery area actively proliferate and express Nestin, a neural stem cell marker, while those in distal regions do not exhibit these traits. The present study investigated the role of perilesional reactive astrocytes (PRAs) in wound healing using the ablation of reactive astrocytes by the conditional knockout of Stat3. The extensive and non-selective ablation of reactive astrocytes in Nestin-Cre:Stat3f/f mice resulted in an exacerbation of injury, marked by increased inflammation and BBB disruption. On the other hand, GFAP-CreERT2:Stat3f/f mice exhibited the partial and selective ablation of the PRAs, while their exacerbation of injury was at the same extent as in Nestin-Cre:Stat3f/f mice. The comparison of these two mouse strains indicates that the PRAs are an essential astrocyte component for wound healing after closed-head injury, and their anti-inflammatory and regenerative functions are significantly affected even by incomplete accumulation. In addition, the reporter gene expression in the PRAs by GFAP-CreERT2 indicated a substantial elimination of these cells and an absence of differentiation into other cell types, despite Nestin expression, after wound healing. Thus, the accumulation and subsequent elimination of PRA are proposed as promising diagnostic and therapeutic avenues to bolster wound healing after closed-head injury.
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Affiliation(s)
- Nitin Sawant
- Biomolecular Organization, Department of Biology, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Airi Watanabe
- Biomolecular Organization, Department of Biology, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Haruna Ueda
- Biomolecular Organization, Department of Biology, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mitsuhiro Morita
- Biomolecular Organization, Department of Biology, Kobe University, Kobe, Hyogo 657-8501, Japan; Application Division, Center of Optical Scattering Image Science, Kobe University, Kobe, Hyogo 657-8501, Japan.
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23
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Pordel S, McCloskey AP, Almahmeed W, Sahebkar A. The protective effects of statins in traumatic brain injury. Pharmacol Rep 2024; 76:235-250. [PMID: 38448729 DOI: 10.1007/s43440-024-00582-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
Traumatic brain injury (TBI), often referred to as the "silent epidemic", is the most common cause of mortality and morbidity worldwide among all trauma-related injuries. It is associated with considerable personal, medical, and economic consequences. Although remarkable advances in therapeutic approaches have been made, current treatments and clinical management for TBI recovery still remain to be improved. One of the factors that may contribute to this gap is that existing therapies target only a single event or pathology. However, brain injury after TBI involves various pathological mechanisms, including inflammation, oxidative stress, blood-brain barrier (BBB) disruption, ionic disturbance, excitotoxicity, mitochondrial dysfunction, neuronal necrosis, and apoptosis. Statins have several beneficial pleiotropic effects (anti-excitotoxicity, anti-inflammatory, anti-oxidant, anti-thrombotic, immunomodulatory activity, endothelial and vasoactive properties) in addition to promoting angiogenesis, neurogenesis, and synaptogenesis in TBI. Supposedly, using agents such as statins that target numerous and diverse pathological mechanisms, may be more effective than a single-target approach in TBI management. The current review was undertaken to investigate and summarize the protective mechanisms of statins against TBI. The limitations of conducted studies and directions for future research on this potential therapeutic application of statins are also discussed.
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Affiliation(s)
- Safoora Pordel
- Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alice P McCloskey
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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24
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Fink SJ, Riegler KE, Guty E, Echemendia RJ, Arnett PA, Merritt VC. A pilot study examining BDNF Val66Met polymorphism and biological sex: Relationships with baseline cognitive functioning in adolescent athletes. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:93-99. [PMID: 36223549 DOI: 10.1080/21622965.2022.2131431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this exploratory study was to examine interactive relationships between a common brain-derived neurotrophic factor (BDNF) polymorphism (Val66Met) and biological sex on cognitive functioning in a sample of healthy adolescent athletes. Participants included 82 student athletes (age: M = 12.85 years, SD = 1.13) who were involved in a clinically-based sports-concussion management program. Athletes completed the ImPACT computerized battery at baseline and provided buccal samples for determination of their BDNF genotype. Two-way ANOVAs were used to evaluate the effect of BDNF genotype (Met+ vs. Met-) and sex (male vs. female) on cognitive functioning (subgroup n's: Female/Met+ = 12, Female/Met- = 26, Male/Met+ = 12, Male/Met- = 32). ANOVAs revealed non-significant main effects for both BDNF genotype and sex across all four cognitive composites. However, there was a significant BDNF genotype by sex interaction for the visual-motor speed composite (p = .015; ηp2 = .073), such that female Met carriers demonstrated better performance than male Met carriers. In contrast, no differences were found on visual-motor speed performance between females and males without a Met allele. Although these results will need to be replicated using larger samples, our preliminary findings lend support to the view that the Met allele may be somewhat neuroprotective in healthy adolescent females.
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Affiliation(s)
- Shayna J Fink
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Kaitlin E Riegler
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Erin Guty
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Ruben J Echemendia
- Concussion Care Clinic, University Orthopedics Center, State College, PA, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Victoria C Merritt
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
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25
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Zhang Z, Gao X, Tian Z, Yang E, Huang Y, Liu D, Dai S, Zhang H, Bao M, Jiang X, Li X, Luo P. Preso enhances mGluR1-mediated excitotoxicity by modulating the phosphorylation of mGluR1-Homer1 complex and facilitating an ER stress after traumatic brain injury. Cell Death Discov 2024; 10:153. [PMID: 38531909 DOI: 10.1038/s41420-024-01916-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/10/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Glutamate receptor (GluR)-mediated excitotoxicity is an important mechanism causing delayed neuronal injury after traumatic brain injury (TBI). Preso, as a core scaffolding protein of postsynaptic density (PSD), is considered an important regulator during excitotoxicity and TBI and combines with glutamate receptors to form functional units for excitatory glutamatergic neurotransmission, and elucidating the mechanisms of these functional units will provide new targets for the treatment of TBI. As a multidomain scaffolding protein, Preso directly interacts with metabotropic GluR (mGluR) and another scaffold protein, Homer. Because the mGluR-Homer complex plays a crucial role in TBI, modulation of this complex by Preso may be an important mechanism affecting the excitotoxic damage to neurons after TBI. Here, we demonstrate that Preso facilitates the interaction between metabotropic mGluR1 and Homer1 to activate mGluR1 signaling and cause excitotoxic neuronal injury and endoplasmic reticulum (ER) stress after TBI. The regulatory effect of Preso on the mGluR1-Homer1 complex is dependent on the direct association between Preso and this complex and also involves the phosphorylation of the interactive binding sites of mGluR1 and Homer1 by Preso. Further studies confirmed that Preso, as an adaptor of cyclin-dependent kinase 5 (CDK5), promotes the phosphorylation of the Homer1-binding site on mGluR1 by CDK5 and thereby enhances the interaction between mGluR1 and Homer1. Preso can also promote the formation of the mGluR1-Homer1 complex by inhibiting the phosphorylation of the Homer1 hinge region by Ca2+/calmodulin-dependent protein kinase IIα (CaMKIIα). Based on these molecular mechanisms, we designed several blocking peptides targeting the interaction between Preso and the mGluR1-Homer1 complex and found that directly disrupting the association between mGluR1 and scaffolding proteins significantly promotes the recovery of motor function after TBI.
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Affiliation(s)
- Zhuoyuan Zhang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- School of Life Science, Northwest University, Xi'an, China
| | - Xiangyu Gao
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhicheng Tian
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Erwan Yang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yutao Huang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Dan Liu
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- School of Life Science, Northwest University, Xi'an, China
| | - Shuhui Dai
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Haofuzi Zhang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Mingdong Bao
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiaofan Jiang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Xin Li
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Peng Luo
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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26
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Liu J, Xin X, Sun J, Fan Y, Zhou X, Gong W, Yang M, Li Z, Wang Y, Yang Y, Gao C. Dual-targeting AAV9P1-mediated neuronal reprogramming in a mouse model of traumatic brain injury. Neural Regen Res 2024; 19:629-635. [PMID: 37721294 PMCID: PMC10581548 DOI: 10.4103/1673-5374.380907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/09/2023] [Accepted: 06/06/2023] [Indexed: 09/19/2023] Open
Abstract
Traumatic brain injury results in neuronal loss and glial scar formation. Replenishing neurons and eliminating the consequences of glial scar formation are essential for treating traumatic brain injury. Neuronal reprogramming is a promising strategy to convert glial scars to neural tissue. However, previous studies have reported inconsistent results. In this study, an AAV9P1 vector incorporating an astrocyte-targeting P1 peptide and glial fibrillary acidic protein promoter was used to achieve dual-targeting of astrocytes and the glial scar while minimizing off-target effects. The results demonstrate that AAV9P1 provides high selectivity of astrocytes and reactive astrocytes. Moreover, neuronal reprogramming was induced by downregulating the polypyrimidine tract-binding protein 1 gene via systemic administration of AAV9P1 in a mouse model of traumatic brain injury. In summary, this approach provides an improved gene delivery vehicle to study neuronal programming and evidence of its applications for traumatic brain injury.
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Affiliation(s)
- Jingzhou Liu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Xin Xin
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Jiejie Sun
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Yueyue Fan
- Academy of Medical Engineering and Translational Medicine, Medical College, Tianjin University, Tianjin, China
| | - Xun Zhou
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Wei Gong
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Meiyan Yang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Zhiping Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Yuli Wang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Yang Yang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
| | - Chunsheng Gao
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China
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27
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Wei YC, Chen CK, Lin C, Shyu YC, Chen PY. Life After Traumatic Brain Injury: Effects on the Lifestyle and Quality of Life of Community-Dwelling Patients. Neurotrauma Rep 2024; 5:159-171. [PMID: 38463415 PMCID: PMC10924056 DOI: 10.1089/neur.2023.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Persons who have experienced traumatic brain injury (TBI) may encounter a range of changes in their physical, mental, and cognitive functions as well as high fatigue levels. To gain a comprehensive understanding of the challenges faced by persons after TBI, we conducted multi-domain assessments among community-dwelling persons with a history of TBI and compared them with age- and sex-matched controls from the Northeastern Taiwan Community Medicine Research Cohort between 2019 and 2021. A total of 168 persons with TBI and 672 non-TBI controls were not different in terms of demographics, comorbidities, and physiological features. However, compared with the non-TBI group, the TBI group had a distinct lifestyle that involved increased reliance on analgesics (6.9% vs. 15.0%, respectively; p = 0.001) and sleep aids (p = 0.008), which negatively affected their quality of life. Moreover, they consumed more coffee (p < 0.001), tea (p < 0.001), cigarettes (p = 0.002), and betel nuts (p = 0.032) than did the non-TBI group. Notably, the use of coffee had a positive effect on the quality of life of the TBI group (F = 4.034; p = 0.045). Further, compared with the non-TBI group, the TBI group had increased risks of sarcopenia (p = 0.003), malnutrition (p = 0.003), and anxiety (p = 0.029) and reduced blood levels of vitamin D (29.83 ± 10.39 vs. 24.20 ± 6.59 ng/mL, respectively; p < 0.001). Overall, the TBI group had a reduced health-related quality of life, with significant challenges related to physical health, mental well-being, social interactions, pain management, and fatigue levels. Moreover, the TBI group experienced poorer sleep quality and efficiency than did the non-TBI group. In conclusion, persons who have sustained brain injuries that require comprehensive and holistic care that includes lifestyle modification, mental and physical healthcare plans, and increased long-term support from their communities. ClinicalTrials.gov (identifier: NCT04839796).
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Affiliation(s)
- Yi-Chia Wei
- Department of Neurology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Chih-Ken Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Chemin Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Pin-Yuan Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
- Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
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28
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Song X, Zhang Y, Tang Z, Du L. Advantages of nanocarriers for basic research in the field of traumatic brain injury. Neural Regen Res 2024; 19:237-245. [PMID: 37488872 PMCID: PMC10503611 DOI: 10.4103/1673-5374.379041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/01/2023] [Accepted: 05/06/2023] [Indexed: 07/26/2023] Open
Abstract
A major challenge for the efficient treatment of traumatic brain injury is the need for therapeutic molecules to cross the blood-brain barrier to enter and accumulate in brain tissue. To overcome this problem, researchers have begun to focus on nanocarriers and other brain-targeting drug delivery systems. In this review, we summarize the epidemiology, basic pathophysiology, current clinical treatment, the establishment of models, and the evaluation indicators that are commonly used for traumatic brain injury. We also report the current status of traumatic brain injury when treated with nanocarriers such as liposomes and vesicles. Nanocarriers can overcome a variety of key biological barriers, improve drug bioavailability, increase intracellular penetration and retention time, achieve drug enrichment, control drug release, and achieve brain-targeting drug delivery. However, the application of nanocarriers remains in the basic research stage and has yet to be fully translated to the clinic.
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Affiliation(s)
- Xingshuang Song
- School of Pharmaceutical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- Department of Pharmaceutics, Beijing Institute of Radiation Medicine, Beijing, China
| | - Yizhi Zhang
- School of Pharmaceutical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- Department of Pharmaceutics, Beijing Institute of Radiation Medicine, Beijing, China
| | - Ziyan Tang
- Department of Pharmaceutics, Beijing Institute of Radiation Medicine, Beijing, China
| | - Lina Du
- School of Pharmaceutical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- Department of Pharmaceutics, Beijing Institute of Radiation Medicine, Beijing, China
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29
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Zhu L, Li Z, Sheng L, Zhang F, Ji W. Ginkgolide A attenuated apoptosis via inhibition of oxidative stress in mice with traumatic brain injury. Heliyon 2024; 10:e24759. [PMID: 38304806 PMCID: PMC10830544 DOI: 10.1016/j.heliyon.2024.e24759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/16/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
Traumatic brain injury (TBI) is the main cause of death among young adults and the main cause of mortality and disability for all ages groups worldwide. Ginkgolides terpenoid compounds unique to Ginkgo biloba, which have protective effects on cardiovascular and cerebrovascular diseases. The aim of this study is to investigate whether ginkgolide A (GA) can improve TBI in mice and whether it can alleviate cell apoptosis in the brain of TBI mice by reducing oxidative stress. Mice received TBI and GA administration for 7 days. Neurological deficits were monitored and brain tissues were examined for molecular pathological markers. TBI mice had more severer neurobehavioral deficits compared with sham group, which could be improved by administration of GA. GA administration improveed Modified Neurological Severity Scale (mNSS) scores, Grid-Walking test and Rotarod test of TBI mice. The apoptosis increased in TBI mice, and reduced after GA treatment. The biomarkers of oxidative stress 8-OHdG and malondialdehyde (MDA) in the brain of TBI mice increased, while SOD reduced. These changes were reversed after GA administration. These outcomes showed that GA could raise neurobehavioral deficiency of TBI mice. GA treatment could attenuate apoptosis in TBI mice by reducing oxidative stress.
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Affiliation(s)
- Lei Zhu
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, China
- Department of Intensive Care Unit, Xuzhou Children's Hospital, Xuzhou, China
| | - Zhengwei Li
- Department of Neurosurgery, Xuzhou Children's Hospital, Xuzhou, China
| | - Liping Sheng
- Department of Intensive Care Unit, Xuzhou Children's Hospital, Xuzhou, China
| | - Fengfei Zhang
- Department of Neurosurgery, Xuzhou Children's Hospital, Xuzhou, China
| | - Wei Ji
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, China
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30
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Zheng H, Haroon K, Liu M, Hu X, Xu Q, Tang Y, Wang Y, Yang GY, Zhang Z. Monomeric CXCL12-Engineered Adipose-Derived Stem Cells Transplantation for the Treatment of Ischemic Stroke. Int J Mol Sci 2024; 25:792. [PMID: 38255866 PMCID: PMC10815250 DOI: 10.3390/ijms25020792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/06/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Adipose-derived stem cells (ASCs) possess therapeutic potential for ischemic brain injury, and the chemokine CXCL12 has been shown to enhance their functional properties. However, the cumulative effects of ASCs when combined with various structures of CXCL12 on ischemic stroke and its underlying molecular mechanisms remain unclear. In this study, we genetically engineered mouse adipose-derived ASCs with CXCL12 variants and transplanted them to the infarct region in a mice transient middle cerebral artery occlusion (tMCAO) model of stroke. We subsequently compared the post-ischemic stroke efficacy of ASC-mCXCL12 with ASC-dCXCL12, ASC-wtCXCL12, and unmodified ASCs. Neurobehavior recovery was assessed using modified neurological severity scores, the hanging wire test, and the elevated body swing test. Changes at the tissue level were evaluated through cresyl violet and immunofluorescent staining, while molecular level alterations were examined via Western blot and real-time PCR. The results of the modified neurological severity score and cresyl violet staining indicated that both ASC-mCXCL12 and ASC-dCXCL12 treatment enhanced neurobehavioral recovery and mitigated brain atrophy at the third and fifth weeks post-tMCAO. Additionally, we observed that ASC-mCXCL12 and ASC-dCXCL12 promoted angiogenesis and neurogenesis, accompanied by an increased expression of bFGF and VEGF in the peri-infarct area of the brain. Notably, in the third week after tMCAO, the ASC-mCXCL12 exhibited superior outcomes compared to ASC-dCXCL12. However, when treated with the CXCR4 antagonist AMD3100, the beneficial effects of ASC-mCXCL12 were reversed. The AMD3100-treated group demonstrated worsened neurological function, aggravated edema volume, and brain atrophy. This outcome is likely attributed to the interaction of monomeric CXCL12 with CXCR4, which regulates the recruitment of bFGF and VEGF. This study introduces an innovative approach to enhance the therapeutic potential of ASCs in treating ischemic stroke by genetically engineering them with the monomeric structure of CXCL12.
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Affiliation(s)
- Haoran Zheng
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Khan Haroon
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Mengdi Liu
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Xiaowen Hu
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Qun Xu
- Health Management Center, Department of Neurology, Renji Hospital of Medical School of Shanghai Jiao Tong University, Shanghai 200127, China;
| | - Yaohui Tang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Yongting Wang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Guo-Yuan Yang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
| | - Zhijun Zhang
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China; (H.Z.); (K.H.); (M.L.); (X.H.); (Y.T.); (Y.W.)
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Cui C, Zhong B, Fan R, Cui Q. HMDD v4.0: a database for experimentally supported human microRNA-disease associations. Nucleic Acids Res 2024; 52:D1327-D1332. [PMID: 37650649 PMCID: PMC10767894 DOI: 10.1093/nar/gkad717] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023] Open
Abstract
MicroRNAs (miRNAs) are a class of important small non-coding RNAs with critical molecular functions in almost all biological processes, and thus, they play important roles in disease diagnosis and therapy. Human MicroRNA Disease Database (HMDD) represents an important and comprehensive resource for biomedical researchers in miRNA-related medicine. Here, we introduce HMDD v4.0, which curates 53530 miRNA-disease association entries from literatures. In comparison to HMDD v3.0 released five years ago, HMDD v4.0 contains 1.5 times more entries. In addition, some new categories have been curated, including exosomal miRNAs implicated in diseases, virus-encoded miRNAs involved in human diseases, and entries containing miRNA-circRNA interactions. We also curated sex-biased miRNAs in diseases. Furthermore, in a case study, disease similarity analysis successfully revealed that sex-biased miRNAs related to developmental anomalies are associated with a number of human diseases with sex bias. HMDD can be freely visited at http://www.cuilab.cn/hmdd.
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Affiliation(s)
- Chunmei Cui
- Department of Biomedical Informatics, Center for Noncoding RNA Medicine, State Key Laboratory of Vascular Homeostasis and Remodeling, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing 100191, China
| | - Bitao Zhong
- Department of Biomedical Informatics, Center for Noncoding RNA Medicine, State Key Laboratory of Vascular Homeostasis and Remodeling, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing 100191, China
| | - Rui Fan
- Department of Biomedical Informatics, Center for Noncoding RNA Medicine, State Key Laboratory of Vascular Homeostasis and Remodeling, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing 100191, China
| | - Qinghua Cui
- Department of Biomedical Informatics, Center for Noncoding RNA Medicine, State Key Laboratory of Vascular Homeostasis and Remodeling, School of Basic Medical Sciences, Peking University, 38 Xueyuan Rd, Beijing 100191, China
- School of Sports Medicine, Wuhan Institute of Physical Education, No. 461 Luoyu Rd. Wuchang District, Wuhan 430079, Hubei Province, China
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Guo Y, Leng Y, Gao C. Blood Urea Nitrogen-to-Albumin Ratio May Predict Mortality in Patients with Traumatic Brain Injury from the MIMIC Database: A Retrospective Study. Bioengineering (Basel) 2024; 11:49. [PMID: 38247926 PMCID: PMC10812946 DOI: 10.3390/bioengineering11010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Traumatic brain injury (TBI), a major global health burden, disrupts the neurological system due to accidents and other incidents. While the Glasgow coma scale (GCS) gauges neurological function, it falls short as the sole predictor of overall mortality in TBI patients. This highlights the need for comprehensive outcome prediction, considering not just neurological but also systemic factors. Existing approaches relying on newly developed biomolecules face challenges in clinical implementation. Therefore, we investigated the potential of readily available clinical indicators, like the blood urea nitrogen-to-albumin ratio (BAR), for improved mortality prediction in TBI. In this study, we investigated the significance of the BAR in predicting all-cause mortality in TBI patients. In terms of research methodologies, we gave preference to machine learning methods due to their exceptional performance in clinical support in recent years. Initially, we obtained data on TBI patients from the Medical Information Mart for Intensive Care database. A total of 2602 patients were included, of whom 2260 survived and 342 died in hospital. Subsequently, we performed data cleaning and utilized machine learning techniques to develop prediction models. We employed a ten-fold cross-validation method to obtain models with enhanced accuracy and area under the curve (AUC) (Light Gradient Boost Classifier accuracy, 0.905 ± 0.016, and AUC, 0.888; Extreme Gradient Boost Classifier accuracy, 0.903 ± 0.016, and AUC, 0.895; Gradient Boost Classifier accuracy, 0.898 ± 0.021, and AUC, 0.872). Simultaneously, we derived the importance ranking of the variable BAR among the included variables (in Light Gradient Boost Classifier, the BAR ranked fourth; in Extreme Gradient Boost Classifier, the BAR ranked sixth; in Gradient Boost Classifier, the BAR ranked fifth). To further evaluate the clinical utility of BAR, we divided patients into three groups based on their BAR values: Group 1 (BAR < 4.9 mg/g), Group 2 (BAR ≥ 4.9 and ≤10.5 mg/g), and Group 3 (BAR ≥ 10.5 mg/g). This stratification revealed significant differences in mortality across all time points: in-hospital mortality (7.61% vs. 15.16% vs. 31.63%), as well as one-month (8.51% vs. 17.46% vs. 36.39%), three-month (9.55% vs. 20.14% vs. 41.84%), and one-year mortality (11.57% vs. 23.76% vs. 46.60%). Building on this observation, we employed the Cox proportional hazards regression model to assess the impact of BAR segmentation on survival. Compared to Group 1, Groups 2 and 3 had significantly higher hazard ratios (95% confidence interval (CI)) for one-month mortality: 1.77 (1.37-2.30) and 3.17 (2.17-4.62), respectively. To further underscore the clinical potential of BAR as a standalone measure, we compared its performance to established clinical scores, like sequential organ failure assessment (SOFA), GCS, and acute physiology score III(APS-III), using receiver operator characteristic curve (ROC) analysis. Notably, the AUC values (95%CI) of the BAR were 0.67 (0.64-0.70), 0.68 (0.65-0.70), and 0.68 (0.65-0.70) for one-month mortality, three-month mortality, and one-year mortality. The AUC value of the SOFA did not significantly differ from that of the BAR. In conclusion, the BAR is a highly influential factor in predicting mortality in TBI patients and should be given careful consideration in future TBI prediction research. The blood urea nitrogen-to-albumin ratio may predict mortality in TBI patients.
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Affiliation(s)
- Yiran Guo
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;
| | - Yuxin Leng
- Critical Care Medicine Department, Peking University Third Hospital, Beijing 100191, China
| | - Chengjin Gao
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;
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Merritt VC, Maihofer AX, Gasperi M, Chanfreau-Coffinier C, Stein MB, Panizzon MS, Hauger RL, Logue MW, Delano-Wood L, Nievergelt CM. Genome-wide association study of traumatic brain injury in U.S. military veterans enrolled in the VA million veteran program. Mol Psychiatry 2024; 29:97-111. [PMID: 37875548 DOI: 10.1038/s41380-023-02304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Large-scale genetic studies of traumatic brain injury (TBI) are lacking; thus, our understanding of the influence of genetic factors on TBI risk and recovery is incomplete. This study aimed to conduct a genome-wide association study (GWAS) of TBI in VA Million Veteran Program (MVP) enrollees. Participants included a multi-ancestry cohort (European, African, and Hispanic ancestries; N = 304,485; 111,494 TBI cases, 192,991 controls). TBI was assessed using MVP survey data and International Classification of Diseases (ICD) codes from the Veterans Health Administration's electronic health record. GWAS was performed using logistic regression in PLINK, and meta-analyzed in METAL. FUMA was used for post-GWAS analysis. Genomic structural equation modeling (gSEM) was conducted to investigate underlying genetic associations with TBI, and bivariate MiXeR was used to estimate phenotype specific and shared polygenicity. SNP-based heritability was 0.060 (SE = 0.004, p = 7.83×10-66). GWAS analysis identified 15 genome-wide significant (GWS) loci at p < 5×10-8. Gene-based analyses revealed 14 gene-wide significant genes; top genes included NCAM1, APOE, FTO, and FOXP2. Gene tissue expression analysis identified the brain as significantly enriched, particularly in the frontal cortex, anterior cingulate cortex, and nucleus accumbens. Genetic correlations with TBI were significant for risk-taking behaviors and psychiatric disorders, but generally not significant for the neurocognitive variables investigated. gSEM analysis revealed stronger associations with risk-taking traits than with psychiatric traits. Finally, the genetic architecture of TBI was similar to polygenic psychiatric disorders. Neurodegenerative disorders including Alzheimer's and Parkinson's disease showed much less polygenicity, however, the proportion of shared variance with TBI was high. This first well-powered GWAS of TBI identified 15 loci including genes relevant to TBI biology, and showed that TBI is a heritable trait with comparable genetic architecture and high genetic correlation with psychiatric traits. Our findings set the stage for future TBI GWASs that focus on injury severity and diversity and chronicity of symptom sequelae.
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Affiliation(s)
- Victoria C Merritt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA.
| | - Adam X Maihofer
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Marianna Gasperi
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | | | - Murray B Stein
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Matthew S Panizzon
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Richard L Hauger
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Department of Psychiatry, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, MA, USA
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Caroline M Nievergelt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
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Langer LK, Bayley MT, Levy C, Munce SEP, Lawrence DW, Tam A, de Oliveira C. Medical Care Among Individuals with a Concussion in Ontario: A Population-based Study. Can J Neurol Sci 2024; 51:87-97. [PMID: 36537153 DOI: 10.1017/cjn.2022.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Concussion affects 1.2% of the population annually; rural regions and children have higher rates of concussion. METHODS Using administrative health care linked databases, all residents of Ontario with a physician diagnosed concussion were identified using ICD-9 code 850 or ICD-10 code S06. Cases were tracked for 2 years for concussion-related health care utilization with relevant specialist physicians (i.e., neurology, otolaryngology, physiatry, psychiatry, ophthalmology). Billing codes, specialist codes, and time from index to visit were analyzed. Factors associated with increased specialist visits were also examined. RESULTS In total, 1,022,588 cases were identified between 2008 and 2014 with 2 years of post-concussion health care utilization available. Follow-up by physician within 3 days of injury occurred in only 14% of cases. Mean time between ED diagnosis and follow-up by a physician was 83.9 days, whereas for rural regions it was >100 days. About half of adults (51.9%) and children (50.3%) had at least 1 specialist visit following concussion. Mean time between injury and first specialist visit was 203.8 (SD 192.9) days for adults, 213.5 (SD 201.0) days for rural adults, and 276.0 (SD 202.6) days for children. There were 67,420 neurology visits, 70,404 psychiatry visits, 13,571 neurosurgery visits, 19,780 physiatry visits, 101,788 ENT visits, and 103,417 ophthalmology visits in the 2 years tracking period. Factors associated with more specialist use included age > 18 years, urban residence, and pre-injury psychiatric history. CONCLUSIONS There are discrepancies in post-concussion health care utilization based on age group and rural/urban residence. Addressing these risk factors could improve concussion care access.
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Affiliation(s)
| | - Mark Thedore Bayley
- KITE Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Charissa Levy
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Toronto ABI Network, Toronto, Canada
| | - Sarah Elizabeth Patricia Munce
- KITE Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - David Wyndham Lawrence
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
- Mt Sinai Hospital, New York, USA
| | - Alan Tam
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Claire de Oliveira
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Canada
- Centre for Health Economics and Hull York Medical School, University of York, UK
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Mu C, Gao M, Xu W, Sun X, Chen T, Xu H, Qiu H. Mechanisms of microRNA-132 in central neurodegenerative diseases: A comprehensive review. Biomed Pharmacother 2024; 170:116029. [PMID: 38128185 DOI: 10.1016/j.biopha.2023.116029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
MicroRNA-132 (miR-132) is a highly conserved molecule that plays a crucial regulatory role in central nervous system (CNS) disorders. The expression levels of miR-132 exhibit variability in various neurological disorders and have been closely linked to disease onset and progression. The expression level of miR-132 in the CNS is regulated by a diverse range of stimuli and signaling pathways, including neuronal migration and integration, dendritic outgrowth, and complexity, synaptogenesis, synaptic plasticity, as well as inflammation and apoptosis activation. The aberrant expression of miR-132 in various central neurodegenerative diseases has garnered widespread attention. Clinical studies have revealed altered miR-132 expression levels in both chronic and acute CNS diseases, positioning miR-132 as a potential biomarker or therapeutic target. An in-depth exploration of miR-132 holds the promise of enhancing our understanding of the mechanisms underlying CNS diseases, thereby offering novel insights and strategies for disease diagnosis and treatment. It is anticipated that this review will assist researchers in recognizing the potential value of miR-132 and in generating innovative ideas for clinical trials related to CNS degenerative diseases.
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Affiliation(s)
- Chenxi Mu
- Basic Medical College, Jiamusi University, Jiamusi 154007, Heilongjiang, China; Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China
| | - Meng Gao
- Basic Medical College, Jiamusi University, Jiamusi 154007, Heilongjiang, China; Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China
| | - Weijing Xu
- Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China; School of Public Health, Jiamusi University, Jiamusi 154007, Heilongjiang, China
| | - Xun Sun
- Basic Medical College, Jiamusi University, Jiamusi 154007, Heilongjiang, China; Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China
| | - Tianhao Chen
- Basic Medical College, Jiamusi University, Jiamusi 154007, Heilongjiang, China; Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China
| | - Hui Xu
- Key Laboratory of Microecology-Immune Regulatory Network and Related Diseases, Jiamusi 154007, Heilongjiang, China.
| | - Hongbin Qiu
- School of Public Health, Jiamusi University, Jiamusi 154007, Heilongjiang, China.
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Akhmadullina EM, Bodrova RA. [The use of transcranial micropolarization in the acute period of severe traumatic brain injury in children]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2024; 101:13-21. [PMID: 38372733 DOI: 10.17116/kurort202410101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Traumatic brain injury, which is often considered as a silent epidemic, is a public health problem. The duration of acute recovery period remains a commonly used criterion for injury severity and clinical management. In this connection, the first stage of medical rehabilitation is carried out in the conditions of resuscitation and neurosurgery department in the hospital providing specialized care. Rehabilitation techniques such as postural training, phase verticalization, individual kinesiotherapy, transcranial micropolarization and etc. are used. OBJECTIVE To assess the effectiveness of using transcranial micropolarization in acute period of severe traumatic brain injury in children. MATERIAL AND METHODS The study on the effectiveness of using transcranial micropolarization in acute period of severe traumatic brain injury in 85 children, divided into 2 groups, was carried out. The study group (42 patients) received the transcranial micropolarization on the 2nd day after severe traumatic brain injury. The control group (43 patients) received only rehabilitation in neurosurgery department. The neurological status in the patients of both groups was assessed on the 2nd day after severe traumatic brain injury in resuscitation department, and after 1, 3 and 6 months. RESULTS AND CONCLUSION The inclusion of transcranial micropolarization in the early medical rehabilitation of children with severe traumatic brain injury increases consciousness level in a shorter period of time, that predicts early patient's socialization.
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Affiliation(s)
- E M Akhmadullina
- Children's Republican Clinical Hospital of the Republic of Tatarstan, Kazan, Russia
- Kazan State Medical Academy - branch of the Russian Medical Academy of Continuing Professional Education, Kazan, Russia
| | - R A Bodrova
- Kazan State Medical Academy - branch of the Russian Medical Academy of Continuing Professional Education, Kazan, Russia
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Li S, Qiu N, Ni A, Hamblin MH, Yin KJ. Role of regulatory non-coding RNAs in traumatic brain injury. Neurochem Int 2024; 172:105643. [PMID: 38007071 PMCID: PMC10872636 DOI: 10.1016/j.neuint.2023.105643] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
Traumatic brain injury (TBI) is a potentially fatal health event that cannot be predicted in advance. After TBI occurs, it can have enduring consequences within both familial and social spheres. Yet, despite extensive efforts to improve medical interventions and tailor healthcare services, TBI still remains a major contributor to global disability and mortality rates. The prompt and accurate diagnosis of TBI in clinical contexts, coupled with the implementation of effective therapeutic strategies, remains an arduous challenge. However, a deeper understanding of changes in gene expression and the underlying molecular regulatory processes may alleviate this pressing issue. In recent years, the study of regulatory non-coding RNAs (ncRNAs), a diverse class of RNA molecules with regulatory functions, has been a potential game changer in TBI research. Notably, the identification of microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs), and other ncRNAs has revealed their potential as novel diagnostic biomarkers and therapeutic targets for TBI, owing to their ability to regulate the expression of numerous genes. In this review, we seek to provide a comprehensive overview of the functions of regulatory ncRNAs in TBI. We also summarize regulatory ncRNAs used for treatment in animal models, as well as miRNAs, lncRNAs, and circRNAs that served as biomarkers for TBI diagnosis and prognosis. Finally, we discuss future challenges and prospects in diagnosing and treating TBI patients in the clinical settings.
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Affiliation(s)
- Shun Li
- Department of Neurology, School of Medicine, University of Pittsburgh, S514 BST, 200 Lothrop Street, Pittsburgh, PA, 15213, USA; Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15261, USA
| | - Na Qiu
- Department of Neurology, School of Medicine, University of Pittsburgh, S514 BST, 200 Lothrop Street, Pittsburgh, PA, 15213, USA; Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15261, USA
| | - Andrew Ni
- Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA
| | - Milton H Hamblin
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, 1212 Webber Hall, 900 University Avenue, Riverside, CA, 92521, USA
| | - Ke-Jie Yin
- Department of Neurology, School of Medicine, University of Pittsburgh, S514 BST, 200 Lothrop Street, Pittsburgh, PA, 15213, USA; Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15261, USA.
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Cole WR, Tegeler CL, Choi YS, Harris TE, Rachels N, Bellini PG, Haight TJ, Gerdes L, Tegeler CH, Roy MJ. Randomized, controlled clinical trial of acoustic stimulation to reduce postconcussive symptoms. Ann Clin Transl Neurol 2024; 11:105-120. [PMID: 37990636 PMCID: PMC10791035 DOI: 10.1002/acn3.51937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/17/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Effective interventions are needed to address postconcussive symptoms. We report the results of randomized, sham-controlled trial of Cereset Research™ Standard Operating Procedures (CR-SOP), a noninvasive, closed-loop, allostatic, acoustic stimulation neurotechnology previously shown to improve insomnia. METHODS Military service members, veterans, or their spouses with persistent symptoms (Neurobehavioral Symptom Inventory [NSI] Score ≥23) after mTBI 3 months to 10 years ago, were randomized to receive 10 sessions of engineered tones linked to brainwaves (LB, intervention), or random engineered tones not linked to brainwaves (NL, sham control). The primary outcome was change in NSI, with secondary outcomes of heart rate variability and self-report measures of sleep, mood, and anxiety. RESULTS Participants (n = 106, 22% female, mean age 37.1, 2.8 deployments, 3.8 TBIs) were randomized 1:1 to LB or NL, with no significant differences between groups at baseline. Among all study participants, the NSI declined from baseline 41.0 to 27.2 after (P < 0.0001), with gains largely sustained at 3 months (31.2) and 6 months (28.4). However, there were no significant differences between the LB (NSI declined from 39.9 at baseline to 28.2 post-intervention, 31.5 at 3 months, and 29.4 at 6 months) and NL (NSI declined from 41.5 at baseline to 26.2, 29.9, and 27.3, respectively. Similar patterns were observed for the PCL5 and PHQ-9 and there was no difference in HRV between groups. INTERPRETATION Ten hours of acoustic stimulation while resting in a zero-gravity chair improves postconcussive symptoms. However, linking tones to brain electrical activity did not reduce symptoms more than random tones. REGISTRATION ClinicalTrials.gov - NCT03649958.
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Affiliation(s)
- Wesley R. Cole
- University of North CarolinaChapel HillNorth CarolinaUSA
| | | | - Y. Sammy Choi
- Womack Army Medical CenterFort BraggNorth CarolinaUSA
| | | | - Nora Rachels
- Womack Army Medical CenterFort BraggNorth CarolinaUSA
| | - Paula G. Bellini
- Uniformed Services UniversityBethesdaMarylandUSA
- Henry M. Jackson FoundationRockvilleMarylandUSA
| | - Thaddeus J. Haight
- Uniformed Services UniversityBethesdaMarylandUSA
- Henry M. Jackson FoundationRockvilleMarylandUSA
| | - Lee Gerdes
- Brain State Technologies, LLCScottsdaleArizonaUSA
| | | | - Michael J. Roy
- Uniformed Services UniversityBethesdaMarylandUSA
- Walter Reed National Military Medical CenterBethesdaMarylandUSA
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Jia M, Guo X, Liu R, Sun L, Wang Q, Wu J. Overexpress miR-132 in the Brain Parenchyma by a Non-invasive Way Improves Tissue Repairment and Releases Memory Impairment After Traumatic Brain Injury. Cell Mol Neurobiol 2023; 44:5. [PMID: 38104297 DOI: 10.1007/s10571-023-01435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023]
Abstract
Traumatic brain injury (TBI) is a serious public health problem worldwide, which could lead to an extremely high percentage of mortality and disability. Current treatment strategies mainly concentrate on neuronal protection and reconstruction, among them, exogenous neural stem cell (NSC) transplantation has long been regarded as the most effective curative treatment. However, due to secondary trauma, transplant rejection, and increased incidence of brain malignant tumor, a non-invasive therapy that enhanced endogenous neurogenesis was more suitable for TBI treatment. Our previous work has shown that miR-132 overexpression could improve neuronal differentiation of NSCs in vitro and in vivo. So, we engineered a new kind of AAV vector named AAV-PHP.eB which can transfect brain parenchyma through intravenous injection to overexpress miR-132 in brain after TBI. We found that miR-132 overexpression could reduce impact volume, promote neurogenesis in the dentate gyrus (DG), accelerate neuroblast migrating into the impact cortex, ameliorate microglia-mediated inflammatory reaction, and ultimately restore learning memory function. Our results revealed that AAV-PHP.eB-based miR-132 overexpression could improve endogenous tissue repairment and release clinical symptoms after traumatic brain injury. This work would provide a new therapeutic strategy for TBI treatment and other neurological disorders characterized by markable neuronal loss and memory impairment. miR-132 overexpression accelerates endogenous neurogenesis and releases TBI-induced tissue repairment and memory impairment. Controlled cortical impact onto the cortex would induce serious cortical injury and microglia accumulation in both cortex and hippocampus. Moreover, endogenous neuroblast could migrate around the injury core. miR-132 overexpression could accelerate neuroblast migration toward the injury core and decreased microglia accumulation in the ipsilateral cortex and hippocampus. miR-132 could be a suitable target on neuroprotective therapy after TBI.
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Affiliation(s)
- Meng Jia
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China
| | - Xi Guo
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China
| | - Ru Liu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China
| | - Lei Sun
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China
| | - Qun Wang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Jianping Wu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China.
- School of Chemistry, Chemical Engineering and Life Sciences, Wuhan University of Technology, Wuhan, 430070, China.
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Wang Y, Hu J, Wu S, Fleishman JS, Li Y, Xu Y, Zou W, Wang J, Feng Y, Chen J, Wang H. Targeting epigenetic and posttranslational modifications regulating ferroptosis for the treatment of diseases. Signal Transduct Target Ther 2023; 8:449. [PMID: 38072908 PMCID: PMC10711040 DOI: 10.1038/s41392-023-01720-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/16/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
Ferroptosis, a unique modality of cell death with mechanistic and morphological differences from other cell death modes, plays a pivotal role in regulating tumorigenesis and offers a new opportunity for modulating anticancer drug resistance. Aberrant epigenetic modifications and posttranslational modifications (PTMs) promote anticancer drug resistance, cancer progression, and metastasis. Accumulating studies indicate that epigenetic modifications can transcriptionally and translationally determine cancer cell vulnerability to ferroptosis and that ferroptosis functions as a driver in nervous system diseases (NSDs), cardiovascular diseases (CVDs), liver diseases, lung diseases, and kidney diseases. In this review, we first summarize the core molecular mechanisms of ferroptosis. Then, the roles of epigenetic processes, including histone PTMs, DNA methylation, and noncoding RNA regulation and PTMs, such as phosphorylation, ubiquitination, SUMOylation, acetylation, methylation, and ADP-ribosylation, are concisely discussed. The roles of epigenetic modifications and PTMs in ferroptosis regulation in the genesis of diseases, including cancers, NSD, CVDs, liver diseases, lung diseases, and kidney diseases, as well as the application of epigenetic and PTM modulators in the therapy of these diseases, are then discussed in detail. Elucidating the mechanisms of ferroptosis regulation mediated by epigenetic modifications and PTMs in cancer and other diseases will facilitate the development of promising combination therapeutic regimens containing epigenetic or PTM-targeting agents and ferroptosis inducers that can be used to overcome chemotherapeutic resistance in cancer and could be used to prevent other diseases. In addition, these mechanisms highlight potential therapeutic approaches to overcome chemoresistance in cancer or halt the genesis of other diseases.
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Affiliation(s)
- Yumin Wang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, PR China
| | - Jing Hu
- Department of Pathogen Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300060, PR China
| | - Shuang Wu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430000, PR China
| | - Joshua S Fleishman
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, 11439, USA
| | - Yulin Li
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, PR China
| | - Yinshi Xu
- Department of Outpatient, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, PR China
| | - Wailong Zou
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, PR China
| | - Jinhua Wang
- Beijing Key Laboratory of Drug Target and Screening Research, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, PR China.
| | - Yukuan Feng
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, PR China.
| | - Jichao Chen
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, PR China.
| | - Hongquan Wang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, PR China.
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Chung JS, Jouk A, Licona NP, Terry JH, Harris OA. In her own words: a phenomenological analysis of stories told by female service members and veterans after traumatic brain injury. Disabil Rehabil 2023; 45:4086-4093. [PMID: 36398683 DOI: 10.1080/09638288.2022.2146766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Given the majority of Service Members and Veterans (SMV) who have sustained a traumatic brain injury (TBI) are male, the female experience with TBI has not been captured in the general understanding of TBI. To improve understanding of the experience of female SMV after TBI utilizing a qualitative phenomenological approach on stories as told by female SMV. MATERIALS AND METHODS Ten female SMV participated in storytelling workshops and created video stories documenting their personal experience with TBI. Workshops were hosted by the VA Palo Alto Health Care System Polytrauma System of Care (VAPAHCS PSC). A grounded thematic analysis was conducted on the video stories. RESULTS Three common content themes emerged from all the stories: (1) negative psychological and emotional impacts of TBI, (2) acceptance and healing process associated with recovery, and (3) military contexts. Negative psychological and emotional impacts included intrapersonal impacts such as negative emotions, suicidal ideation, and dealing with cognitive and physical challenges, and interpersonal impacts in relationships and loss of independence. Notably, all the stories acknowledged an acceptance and healing process, characterized by several subthemes including motivational factors, TBI education, spirituality, and advocacy work. Lastly, each story mentioned military context, highlighting the unique experience within this population. CONCLUSIONS This phenomenological examination adds evidence-based understanding to the experience after TBI among female SMV. Each story uncovered nuanced and multifaceted issues that women experience in their TBI recovery. Our findings provide context to guide future intervention on the care, support, and TBI recovery for the female SMV population.
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Affiliation(s)
- Joyce S Chung
- Polytrauma System of Care, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Alexandra Jouk
- Polytrauma System of Care, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Nytzia P Licona
- Polytrauma System of Care, VA Palo Alto Health Care System, Palo Alto, CA, USA
- University of Illinois Chicago, Palo Alto, CA, USA
| | - Jennifer H Terry
- Polytrauma System of Care, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Odette A Harris
- Polytrauma System of Care, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Stanford University, Stanford, CA, USA
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Corrick S, Lesyk N, Yang E, Campbell S, Villa-Roel C, Rowe BH. Role of sex and gender in concussion outcome differences among patients presenting to the emergency department: a systematic review. Inj Prev 2023; 29:537-544. [PMID: 37507213 DOI: 10.1136/ip-2022-044822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This systematic review aimed to identify research involving adults presenting to the emergency department (ED) with a concussion to document the reporting of sex and/or gender according to the Canadian Institutes of Health Research (CIHR) guidelines, the prevalence of sex and gender-based analysis (SGBA) and to summarise sex and/or gender-based differences in ED presentation, management and outcomes. DESIGN Systematic review. METHODS Electronic databases and grey literature were searched to identify studies that recruited adult patients with concussion from the ED. Two independent reviewers identified eligible studies, assessed quality and extracted data. A descriptive summary of the evidence was generated, and sex and/or gender reporting was examined for accuracy according to standardised criteria. RESULTS Overall, 126 studies were included in the analyses. A total of 80 (64%) studies reported sex and/or gender as demographic information, of which 51 (64%) included sex and/or gender in their analysis; however, 2 (3%) studies focused on an SGBA. Sex was more accurately reported in alignment with CIHR definitions than gender (94% vs 12%; p<0.0001). In total, 25 studies used an SGBA for outcomes of interest. Males and females experience different causes of concussion, 60% of studies documented that females had less frequent CT scanning while in the ED, and 57% of studies reported that postconcussion syndrome was more prevalent in females and women. CONCLUSION This systematic review highlighted that sex is reported more accurately than gender, approximately half of studies did not report either sex and/or gender as demographic information, and one-third of studies did not include SGBA. There were important sex and gender differences in the cause, ED presentation, management and outcomes of concussions. PROSPERO REGISTRATION NUMBER CRD42021258613.
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Affiliation(s)
- Shaina Corrick
- Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas Lesyk
- Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Esther Yang
- Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Villa-Roel
- Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Brian H Rowe
- Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Clinical Epidemiology, School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
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Teterina A, Zulbayar S, Mollayeva T, Chan V, Colantonio A, Escobar M. Gender versus sex in predicting outcomes of traumatic brain injury: a cohort study utilizing large administrative databases. Sci Rep 2023; 13:18453. [PMID: 37891419 PMCID: PMC10611793 DOI: 10.1038/s41598-023-45683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023] Open
Abstract
Understanding the factors associated with elevated risks and adverse consequences of traumatic brain injury (TBI) is an integral part of developing preventive measures for TBI. Brain injury outcomes differ based on one's sex (biological characteristics) and gender (social characteristics reflecting norms and relationships), however, whether it is sex or gender that drives differences in early (30-day) mortality and discharge location post-TBI is not well understood. In the absence of a gender variable in existing data, we developed a method for "measuring gender" in 276,812 residents of Ontario, Canada who entered the emergency department and acute care hospitals with a TBI diagnostic code between April 1st, 2002, and March 31st, 2020. We applied logistic regression to analyse differences in diagnostic codes between the sexes and to derive a gender score that reflected social dimensions. We used the derived gender score along with a sex variable to demonstrate how it can be used to separate the relationship between sex, gender and TBI outcomes after severe TBI. Sex had a significant effect on early mortality after severe TBI with a rate ratio (95% confidence interval (CI)) of 1.54 (1.24-1.91). Gender had a more significant effect than sex on discharge location. A person expressing more "woman-like" characteristics had lower odds of being discharged to rehabilitation versus home with odds ratio (95% CI) of 0.54 (0.32-0.88). The method we propose offers an opportunity to measure a gender effect independently of sex on TBI outcomes.
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Affiliation(s)
- Anastasia Teterina
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
| | - Suvd Zulbayar
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
| | - Tatyana Mollayeva
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Acquired Brain Injury Research Lab, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Vincy Chan
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Acquired Brain Injury Research Lab, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Acquired Brain Injury Research Lab, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.
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Bharadwaj VN, Sahbaie P, Shi X, Irvine KA, Yeomans DC, Clark JD. Effect of Voluntary Exercise on Endogenous Pain Control Systems and Post-traumatic Headache in Mice. THE JOURNAL OF PAIN 2023; 24:1859-1874. [PMID: 37271350 DOI: 10.1016/j.jpain.2023.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/06/2023]
Abstract
Traumatic brain injury (TBI) can cause acute and chronic pain along with motor, cognitive, and emotional problems. Although the mechanisms are poorly understood, previous studies suggest disruptions in endogenous pain modulation may be involved. Voluntary exercise after a TBI has been shown to reduce some consequences of injury including cognitive impairment. We hypothesized, therefore, that voluntary exercise could augment endogenous pain control systems in a rodent model of TBI. For these studies, we used a closed-head impact procedure in male mice modeling mild TBI. We investigated the effect of voluntary exercise on TBI-induced hindpaw nociceptive sensitization, diffuse noxious inhibitory control failure, and periorbital sensitization after bright light stress, a model of post-traumatic headache. Furthermore, we investigated the effects of exercise on memory, circulating markers of brain injury, neuroinflammation, and spinal cord gene expression. We observed that exercise significantly reduced TBI-induced hindpaw allodynia and periorbital allodynia in the first week following TBI. We also showed that exercise improved the deficits associated with diffuse noxious inhibitory control and reduced bright light stress-induced allodynia up to 2 months after TBI. In addition, exercise preserved memory and reduced TBI-induced increases in spinal BDNF, CXCL1, CXCL2, and prodynorphin expression, all genes previously linked to TBI-induced nociceptive sensitization. Taken together, our observations suggest that voluntary exercise may reduce pain after TBI by reducing TBI-induced changes in nociceptive signaling and preserving endogenous pain control systems. PERSPECTIVE: This article evaluates the effects of exercise on pain-related behaviors in a preclinical model of traumatic brain injury (TBI). The findings show that exercise reduces nociceptive sensitization, loss of diffuse noxious inhibitory control, memory deficits, and spinal nociception-related gene expression after TBI. Exercise may reduce or prevent pain after TBI.
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Affiliation(s)
- Vimala N Bharadwaj
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California.
| | - Peyman Sahbaie
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Xiaoyou Shi
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Karen-Amanda Irvine
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - David C Yeomans
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California
| | - J David Clark
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Mann G, Troeung L, Martini A. Sex/gender differences in service use patterns, clinical outcomes and mortality risk for adults with acquired brain injury: a retrospective cohort study (ABI-RESTART). J Rehabil Med 2023; 55:jrm5303. [PMID: 37698453 PMCID: PMC10506514 DOI: 10.2340/jrm.v55.5303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/11/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To identify sex/gender differences in functional, psychosocial and service use patterns in community-based post-acute care for acquired brain injury. Design: Retrospective cohort study. SUBJECTS/PATIENTS Adults with acquired brain injury enrolled in post-acute neurorehabilitation and disability support in Western Australia (n = 1,011). METHODS UK Functional Independence Measure and Functional Assessment Measure (FIM + FAM), Mayo-Portland Adaptability Inventory-4, goal attainment, length of stay (LOS), number of episodes of care and deaths were evaluated using routinely collected clinical and linked administrative data. RESULTS At admission, women were older (p < 0.001) and displayed poorer functional independence (FIM + FAM; p < 0.05) compared with men. At discharge, there were no differences in goal attainment, psychosocial function or functional independence between men and women. Both groups demonstrated functional gains; however, women demonstrated clinically significant gains (+ 15.1, p < 0.001) and men did not (+ 13.7, p < 0.001). Women and men had equivalent LOS (p = 0.205). Aboriginal and/or Torres Strait Islander status predicted longer LOS for women but not for men. Being partnered predicted reduced LOS for women but not men. Women had a higher risk of multiple episodes of care (p < 0.001), but not death (p = 0.409), compared with that of men. CONCLUSION At admission to rehabilitation and disability support services for acquired brain injury, women have poorer functional independence and higher risk of multiple episodes of care, compared with men, suggesting greater disability in the community. By the time of discharge from these services, women and men make equivalent functional and psychosocial gains. The higher risk of multiple episodes of care for women relative to men suggest women may need additional post-discharge support, to avoid readmission.
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Affiliation(s)
- Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Australia.
| | - Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Australia.
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Australia.
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46
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Wang L. Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy. Open Life Sci 2023; 18:20220686. [PMID: 37671101 PMCID: PMC10476475 DOI: 10.1515/biol-2022-0686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 09/07/2023] Open
Abstract
Neonatal hypoxic ischemic encephalopathy is a common disease, which is caused by fetal hypoxia, asphyxia, and other reasons. It may cause sequelae of the nervous system and even death in children. Computer tomography examination can clarify the scope and location of the disease and provide the basis for clinical treatment and prognosis. Relevant personnel analyzed the symptoms of ischemic hypoxia and found that ischemia and hypoxia were the main causes of encephalopathy. Neonatal ischemia and hypoxia are easy to cause serious damage. At present, with the development of medicine, the function of the human brain is the most important issue in natural science. The law of neural activity and the role of molecular cells, organs, and systems have fundamental construction significance for the prevention and treatment of nerve and mental diseases. By analyzing the value of the diagnosis of neonatal hypoxic-ischemic encephalopathy in the analysis of experimental data, by setting the newborns in the controlled group and the trial group as experimental subjects, this paper analyzed the situation of newborns in terms of body temperature, body weight, and respiratory rate, and used Apgar score to score these standards. It was found that the score of the controlled group was 7 and above, and the score of the trial group was below 7. It was found that the Apgar scoring method was more simple. Then, the newborns were analyzed by cord blood gas analysis. It was found that most of the data in the control group were between 7.8 and 8.4, and the data in the trial group were between 5.8 and 7.1. The umbilical blood gas analysis score of the experimental group was lower than that of the control group. By comparing the satisfaction of cord blood gas analysis and the Apgar score, it was found that the satisfaction of cord blood gas analysis was 24.06% higher than that of the Apgar score.
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Affiliation(s)
- Lijun Wang
- Zhengzhou Institute of Industrial Application Technology, Zhengzhou451100, Henan Province, China
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47
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Lin CC, Chen HY, Tseng CY, Yang CC. Effect of Acupuncture on Recovery of Consciousness in Patients with Acute Traumatic Brain Injury: A Multi-Institutional Cohort Study. Healthcare (Basel) 2023; 11:2267. [PMID: 37628465 PMCID: PMC10454345 DOI: 10.3390/healthcare11162267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Traumatic brain injury (TBI) causes cognitive dysfunction and long-term impairments. This study aims to examine the effectiveness of acupuncture on the recovery of consciousness in TBI patients. This is a retrospective, multi-institutional cohort study. We enrolled patients with newly diagnosed TBI from 1 January 2007 to 3 August 2021, aged 20 years and older, from the Chang Gung Research Database (CGRD). The outcome was defined based on the difference between the first and last Glasgow Coma Scale (GCS). A total of 2163 TBI patients were analyzed, and 237 (11%) received acupuncture in the treatment period. Generally, the initial GCS was lower in the acupuncture users (11 vs. 14). For the results of our study, a higher proportion of acupuncture patients achieved significant improvement (GCS differences ≥ 3) compared to non-acupuncture users (46.0% vs. 22.4%, p-value < 0.001). The acupuncture users had a 2.11 times higher chance of achieving a significant improvement when considering all assessable covariates (adjusted odds ratio (aOR) 2, 11, 95% confidence interval [CI]: 1.31-3.40; p-value = 0.002). Using 1:1 propensity score matching (PSM), the acupuncture users still had better outcomes than the non-acupuncture users (45.3% vs. 32.9%, p-value = 0.020). In conclusion, this study suggests that acupuncture treatment may be beneficial for TBI patients.
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Affiliation(s)
- Chun-Chieh Lin
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
| | - Hsing-Yu Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 330036, Taiwan;
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chu-Yao Tseng
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
| | - Chien-Chung Yang
- Division of Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan; (C.-C.L.); (C.-Y.T.)
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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Tsitsipanis C, Miliaraki M, Paflioti E, Lazarioti S, Moustakis N, Ntotsikas K, Theofanopoulos A, Ilia S, Vakis A, Simos P, Venihaki M. Inflammation biomarkers IL‑6 and IL‑10 may improve the diagnostic and prognostic accuracy of currently authorized traumatic brain injury tools. Exp Ther Med 2023; 26:364. [PMID: 37408863 PMCID: PMC10318605 DOI: 10.3892/etm.2023.12063] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/04/2023] [Indexed: 07/07/2023] Open
Abstract
Traumatic brain injury (TBI) is currently one of the leading causes of mortality and disability worldwide. At present, no reliable inflammatory or specific molecular neurobiomarker exists in any of the standard models proposed for TBI classification or prognostication. Therefore, the present study was designed to assess the value of a group of inflammatory mediators for evaluating acute TBI, in combination with clinical, laboratory and radiological indices and prognostic clinical scales. In the present single-centre, prospective observational study, 109 adult patients with TBI, 20 adult healthy controls and a pilot group of 17 paediatric patients with TBI from a Neurosurgical Department and two intensive care units of University General Hospital of Heraklion, Greece were recruited. Blood measurements using the ELISA method, of cytokines IL-6, IL-8 and IL-10, ubiquitin C-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein, were performed. Compared with those in healthy control individuals, elevated IL-6 and IL-10 but reduced levels of IL-8 were found on day 1 in adult patients with TBI. In terms of TBI severity classifications, higher levels of IL-6 (P=0.001) and IL-10 (P=0.009) on day 1 in the adult group were found to be associated with more severe TBI according to widely used clinical and functional scales. Moreover, elevated IL-6 and IL-10 in adults were found to be associated with more serious brain imaging findings (rs<0.442; P<0.007). Subsequent multivariate logistic regression analysis in adults revealed that early-measured (day 1) IL-6 [odds ratio (OR)=0.987; P=0.025] and UCH-L1 (OR=0.993; P=0.032) are significant independent predictors of an unfavourable outcome. In conclusion, results from the present study suggest that inflammatory molecular biomarkers may prove to be valuable diagnostic and prognostic tools for TBI.
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Affiliation(s)
- Christos Tsitsipanis
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Marianna Miliaraki
- Pediatric Intensive Care Unit, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Elina Paflioti
- Department of Clinical Chemistry, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Sofia Lazarioti
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Nikolaos Moustakis
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Konstantinos Ntotsikas
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | | | - Stavroula Ilia
- Pediatric Intensive Care Unit, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Antonis Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Maria Venihaki
- Department of Clinical Chemistry, School of Medicine, University of Crete, 70013 Heraklion, Greece
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49
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Ding Y, Chen F, Yang W, Fu X, Xie Y. SENP5 deteriorates traumatic brain injury via SUMO2-dependent suppression of E2F1 SUMOylation. Acta Biochim Biophys Sin (Shanghai) 2023; 55:1193-1203. [PMID: 37403456 PMCID: PMC10448041 DOI: 10.3724/abbs.2023121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/09/2023] [Indexed: 07/06/2023] Open
Abstract
Traumatic brain injury (TBI) represents a main public health concern during the past decade, attracting considerable interest because of its rising prevalence, wide-ranging risk factors and lifelong familial and societal influence. SUMO2 can conjugate to substrates upon various cellular stresses. Nevertheless, whether and how SUMO2-specific proteases partake in TBI is less understood. The aim of this study is to dissect the effects of SUMO-specific peptidase 5 (SENP5) on accentuating TBI in rats in an effort to unveil its underlying mechanism. SENP5 is overexpressed in hippocampal tissues of TBI rats, and inhibition of SENP5 reduces neurological function scores, decreases brain water content, inhibits apoptosis in hippocampal tissues, and attenuates brain injury caused in rats. Moreover, SENP5 inhibits the SUMOylation level of E2F transcription factor 1 (E2F1) and increases the protein expression of E2F1. Silencing of E2F1 blocks the p53 signaling pathway. Overexpression of E2F1 partially reverses the protective effect of sh-SENP5 on TBI in rats. These findings reveal an essential role of SENP5 and the SUMOylation status of E2F1 in the TBI development.
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Affiliation(s)
- Yanfu Ding
- College of Pharmaceutical ScienceZhejiang University of TechnologyHangzhou310000China
- Kanglin Biotec (Hangzhou) Co.LtdHangzhou310000China
| | - Feifei Chen
- Kanglin Biotec (Hangzhou) Co.LtdHangzhou310000China
| | - Weitao Yang
- Kanglin Biotec (Hangzhou) Co.LtdHangzhou310000China
| | - Xiaobin Fu
- Kanglin Biotec (Hangzhou) Co.LtdHangzhou310000China
| | - Yuanyuan Xie
- College of Pharmaceutical ScienceZhejiang University of TechnologyHangzhou310000China
- Collaborative Innovation Center of Yangtze River Delta Region Green PharmaceuticalZhejiang University of TechnologyHangzhou310000China
- Key Laboratory of Pharmaceutical Engineering of Zhejiang ProvinceHangzhou310000China
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50
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Suen AO, Chen F, Wang S, Li Z, Zhu J, Yang Y, Conn O, Lopez K, Cui P, Wechsler L, Cross A, Fiskum G, Kozar R, Hu P, Miller C, Zou L, Williams B, Chao W. Extracellular RNA Sensing Mediates Inflammation and Organ Injury in a Murine Model of Polytrauma. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2023; 210:1990-2000. [PMID: 37133342 PMCID: PMC10235856 DOI: 10.4049/jimmunol.2300103] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/06/2023] [Indexed: 05/04/2023]
Abstract
Severe traumatic injury leads to marked systemic inflammation and multiorgan injury. Endogenous drivers such as extracellular nucleic acid may play a role in mediating innate immune response and the downstream pathogenesis. Here, we explored the role of plasma extracellular RNA (exRNA) and its sensing mechanism in inflammation and organ injury in a murine model of polytrauma. We found that severe polytrauma-bone fracture, muscle crush injury, and bowel ischemia-induced a marked increase in plasma exRNA, systemic inflammation, and multiorgan injury in mice. Plasma RNA profiling with RNA sequencing in mice and humans revealed a dominant presence of miRNAs and marked differential expression of numerous miRNAs after severe trauma. Plasma exRNA isolated from trauma mice induced a dose-dependent cytokine production in macrophages, which was almost abolished in TLR7-deficient cells but unchanged in TLR3-deficient cells. Moreover, RNase or specific miRNA inhibitors against the selected proinflammatory miRNAs (i.e., miR-7a-5p, miR-142, let-7j, miR-802, and miR-146a-5p) abolished or attenuated trauma plasma exRNA-induced cytokine production, respectively. Bioinformatic analyses of a group of miRNAs based on cytokine readouts revealed that high uridine abundance (>40%) is a reliable predictor in miRNA mimic-induced cytokine and complement production. Finally, compared with the wild-type, TLR7-knockout mice had attenuated plasma cytokine storm and reduced lung and hepatic injury after polytrauma. These data suggest that endogenous plasma exRNA of severely injured mice and ex-miRNAs with high uridine abundance prove to be highly proinflammatory. TLR7 sensing of plasma exRNA and ex-miRNAs activates innate immune responses and plays a role in inflammation and organ injury after trauma.
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Affiliation(s)
- Andrew O. Suen
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | - Fengqian Chen
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Sheng Wang
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Ziyi Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jing Zhu
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Yang Yang
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Olivia Conn
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Kerri Lopez
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Ping Cui
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Laurence Wechsler
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Alan Cross
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Gary Fiskum
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Rosemary Kozar
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Peter Hu
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Catriona Miller
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
- Enroute Care Division, Department of Aeromedical Research, U.S. Air Force School of Aerospace Medicine, Wright Patterson Air Force Base, Dayton, OH
| | - Lin Zou
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Brittney Williams
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
| | - Wei Chao
- Center for Shock, Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, MD
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