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Hardaker N, King D, Hume PA, Stewart T, Sims S, Basu I, Shilton B, Selfe J. Female RNA concussion (FeRNAC) study: assessing hormone profiles and salivary RNA in females with concussion by emergency departments in New Zealand: a study protocol. BMC Neurol 2024; 24:149. [PMID: 38698312 PMCID: PMC11064333 DOI: 10.1186/s12883-024-03653-9] [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: 02/25/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Females of reproductive age with concussion report a greater number of symptoms that can be more severe and continue for longer than age matched males. Underlying mechanisms for sex differences are not well understood. Short non-coding Ribonucleic Acids (sncRNAs) are candidate salivary biomarkers for concussion and have been studied primarily in male athletes. Female sex hormones influence expression of these biomarkers, and it remains unclear whether a similar pattern of sncRNA expression would be observed in females following concussion. This study aims to evaluate recovery time, the ratio of salivary sncRNAs and symptom severity across different hormone profiles in females presenting to emergency departments (ED) with concussion and, to investigate the presence of low energy availability (LEA) as a potential modifier of concussion symptoms. METHODS This prospective cohort study recruits participants from New Zealand EDs who are biologically female, of reproductive age (16-50 years) and with a confirmed diagnosis of concussion from an ED healthcare professional. Participants are excluded by ED healthcare professionals from study recruitment as part of initial routine assessment if they have a pre-diagnosed psychiatric condition, neurological condition (i.e., epilepsy, cerebral palsy) or more than three previously diagnosed concussions. Participants provide a saliva sample for measurement of sncRNA's, and online survey responses relating to hormone profile and symptom recovery at 7-day intervals after injury until they report a full return to work/study. The study is being performed in accordance with ethical standards of the Declaration of Helsinki with ethics approval obtained from the Health and Disability Ethics Committee (HDEC #2021 EXP 11655), Auckland University of Technology Ethics Committee (AUTEC #22/110) and locality consent through Wellington hospital research office. DISCUSSION If saliva samples confirm presence of sncRNAs in females with concussion, it will provide evidence of the potential of saliva sampling as an objective tool to aid in diagnosis of, and confirmation of recovery from, concussion. Findings will determine whether expression of sncRNAs is influenced by steroid hormones in females and may outline the need for sex specific application and interpretation of sncRNAs as a clinical and/or research tool. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) registration number ACTRN12623001129673.
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Affiliation(s)
- Natalie Hardaker
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand.
| | - Doug King
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Department of Sport and Exercise Sciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Patria A Hume
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Technology and Policy Lab - Law School, The University of Western Australia, Perth, Australia
| | - Tom Stewart
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
| | - Stacy Sims
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
| | | | | | - James Selfe
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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Symons GF, Gregg MC, Hicks AJ, Rowe CC, Shultz SR, Ponsford JL, Spitz G. Altered grey matter structural covariance in chronic moderate-severe traumatic brain injury. Sci Rep 2024; 14:1728. [PMID: 38242923 PMCID: PMC10799053 DOI: 10.1038/s41598-023-50396-7] [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: 08/29/2023] [Accepted: 12/19/2023] [Indexed: 01/21/2024] Open
Abstract
Traumatic brain injury (TBI) alters brain network connectivity. Structural covariance networks (SCNs) reflect morphological covariation between brain regions. SCNs may elucidate how altered brain network topology in TBI influences long-term outcomes. Here, we assessed whether SCN organisation is altered in individuals with chronic moderate-severe TBI (≥ 10 years post-injury) and associations with cognitive performance. This case-control study included fifty individuals with chronic moderate-severe TBI compared to 75 healthy controls recruited from an ongoing longitudinal head injury outcome study. SCNs were constructed using grey matter volume measurements from T1-weighted MRI images. Global and regional SCN organisation in relation to group membership and cognitive ability was examined using regression analyses. Globally, TBI participants had reduced small-worldness, longer characteristic path length, higher clustering, and higher modularity globally (p < 0.05). Regionally, TBI participants had greater betweenness centrality (p < 0.05) in frontal and central areas of the cortex. No significant associations were observed between global network measures and cognitive ability in participants with TBI (p > 0.05). Chronic moderate-severe TBI was associated with a shift towards a more segregated global network topology and altered organisation in frontal and central brain regions. There was no evidence that SCNs are associated with cognition.
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Affiliation(s)
- Georgia F Symons
- Department of Neuroscience, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Matthew C Gregg
- Monash-Epworth Rehabilitation Research Centre, Ground Floor, 185-187 Hoddle St, Richmond, 3121, Australia
| | - Amelia J Hicks
- Monash-Epworth Rehabilitation Research Centre, Ground Floor, 185-187 Hoddle St, Richmond, 3121, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, 145 Studley Rd, Heidelberg, VIC, 3084, Australia
| | - Sandy R Shultz
- Department of Neuroscience, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Health Sciences, Vancouver Island University, 900 Fifth Street, Nanaimo, BC, V9R 5S5, Canada
| | - Jennie L Ponsford
- Monash-Epworth Rehabilitation Research Centre, Ground Floor, 185-187 Hoddle St, Richmond, 3121, Australia
| | - Gershon Spitz
- Department of Neuroscience, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Monash-Epworth Rehabilitation Research Centre, Ground Floor, 185-187 Hoddle St, Richmond, 3121, Australia
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Feinberg C, Mayes KD, Portman E, Carr C, Mannix R. Non-invasive fluid biomarkers in the diagnosis of mild traumatic brain injury (mTBI): a systematic review. J Neurol Neurosurg Psychiatry 2024; 95:184-192. [PMID: 37147117 DOI: 10.1136/jnnp-2023-331220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/10/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Despite approximately 55.9 million annual mild traumatic brain injuries (mTBIs) worldwide, the accurate diagnosis of mTBI continues to challenge clinicians due to symptom ambiguity, reliance on subjective report and presentation variability. Non-invasive fluid biomarkers of mTBI offer a biological measure to diagnose and monitor mTBI without the need for blood draws or neuroimaging. The objective of this study is to systematically review the utility of such biomarkers to diagnose mTBI and predict disease progression. METHODS A systematic review performed in PubMed, Scopus, Cochrane and Web of Science followed by a manual search of references without a specified timeframe. Search strings were generated and run (27 June 2022) by a research librarian. Studies were included if they: (1) included human mTBI subjects, (2) assessed utility of a non-invasive biomarker and (3) published in English. Exclusion criteria were (1) non-mTBI subjects, (2) mTBI not assessed separately from moderate/severe TBI, (3) required intracranial haemorrhage or (4) solely assesses genetic susceptibility to mTBI. RESULTS A total of 29 studies from 27 subject populations (1268 mTBI subjects) passed the inclusion and exclusion criteria. Twelve biomarkers were studied. Salivary RNAs, including microRNA, were assessed in 11 studies. Cortisol and melatonin were assessed in four and three studies, respectively. Eight salivary and two urinary biomarkers contained diagnostic or disease monitoring capability. DISCUSSION This systematic review identified several salivary and urinary biomarkers that demonstrate the potential to be used as a diagnostic, prognostic and monitoring tool for mTBI. Further research should examine miRNA-based models for diagnostic and predictive utility in patients with mTBI. PROSPERO REGISTRATION NUMBER CRD42022329293.
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Affiliation(s)
- Charles Feinberg
- University of Massachusetts Chan Medical School TH Chan School of Medicine, Worcester, Massachusetts, USA
| | | | - Ellie Portman
- Department of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Catherine Carr
- University of Massachusetts Chan Medical School TH Chan School of Medicine, Worcester, Massachusetts, USA
| | - Rebekah Mannix
- Department of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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Săsăran MO, Bănescu C. Role of salivary miRNAs in the diagnosis of gastrointestinal disorders: a mini-review of available evidence. Front Genet 2023; 14:1228482. [PMID: 37456668 PMCID: PMC10346860 DOI: 10.3389/fgene.2023.1228482] [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] [Received: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
MiRNAs are short, non-coding RNA molecules, which are involved in the regulation of gene expression and which play an important role in various biological processes, including inflammation and cell cycle regulation. The possibility of detecting their extracellular expression, within body fluids, represented the main background for their potential use as non-invasive biomarkers of various diseases. Salivary miRNAs particularly gained interest recently due to the facile collection of stimulated/unstimulated saliva and their stability among healthy subjects. Furthermore, miRNAs seem to represent biomarker candidates of gastrointestinal disorders, with miRNA-based therapeutics showing great potential in those conditions. This review aimed to highlight available evidence on the role of salivary miRNAs in different gastrointestinal conditions. Most salivary-based miRNA studies available in the literature that focused on pathologies of the gastrointestinal tract have so far been conducted on pancreatic cancer patients and delivered reliable results. A few studies also showed the diagnostic utility of salivary miRNAs in conditions such as esophagitis, esophageal cancer, colorectal cancer, or inflammatory bowel disease. Moreover, several authors showed that salivary miRNAs may confidently be used as biomarkers of gastric cancer, but the use of salivary miRNA candidates in gastric inflammation and pre-malignant lesions, essential stages of Correa's cascade, is still put into question. On the other hand, besides miRNAs, other salivary omics have shown biomarker potential in gastro-intestinal conditions. The limited available data suggest that salivary miRNAs may represent reliable biomarker candidates for gastrointestinal conditions. However, their diagnostic potential requires validation through future research, performed on larger cohorts.
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Affiliation(s)
- Maria Oana Săsăran
- Department of Pediatrics 3, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, Târgu Mureș, Romania
| | - Claudia Bănescu
- Genetics Department, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Targu Mures, Romania
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Sullivan R, Montgomery A, Scipioni A, Jhaveri P, Schmidt AT, Hicks SD. Confounding Factors Impacting microRNA Expression in Human Saliva: Methodological and Biological Considerations. Genes (Basel) 2022; 13:genes13101874. [PMID: 36292760 PMCID: PMC9602126 DOI: 10.3390/genes13101874] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/04/2022] Open
Abstract
There is growing interest in saliva microRNAs (miRNAs) as non-invasive biomarkers for human disease. Such an approach requires understanding how differences in experimental design affect miRNA expression. Variations in technical methodologies, coupled with inter-individual variability may reduce study reproducibility and generalizability. Another barrier facing salivary miRNA biomarker research is a lack of recognized “control miRNAs”. In one of the largest studies of human salivary miRNA to date (922 healthy individuals), we utilized 1225 saliva samples to quantify variability in miRNA expression resulting from aligner selection (Bowtie1 vs. Bowtie2), saliva collection method (expectorated vs. swabbed), RNA stabilizer (presence vs. absence), and individual biological factors (sex, age, body mass index, exercise, caloric intake). Differential expression analyses revealed that absence of RNA stabilizer introduced the greatest variability, followed by differences in methods of collection and aligner. Biological factors generally affected a smaller number of miRNAs. We also reported coefficients of variations for 643 miRNAs consistently present in saliva, highlighting several salivary miRNAs to serve as reference genes. Thus, the results of this analysis can be used by researchers to optimize parameters of salivary miRNA measurement, exclude miRNAs confounded by numerous biologic factors, and identify appropriate miRNA controls.
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Affiliation(s)
- Rhea Sullivan
- Department of Pediatrics, Penn State Hershey College of Medicine, Hershey, PA 17033, USA
| | - Austin Montgomery
- Department of Pediatrics, Penn State Hershey College of Medicine, Hershey, PA 17033, USA
| | - Anna Scipioni
- Department of Pediatrics, Penn State Hershey College of Medicine, Hershey, PA 17033, USA
- Department of Obstetrics, Morsani College of Medicine, University of Southern Florida, Tampa, FL 33606, USA
| | - Pooja Jhaveri
- Department of Pediatrics, Penn State Hershey College of Medicine, Hershey, PA 17033, USA
| | - Adam T. Schmidt
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX 79409, USA
| | - Steven D. Hicks
- Department of Pediatrics, Penn State Hershey College of Medicine, Hershey, PA 17033, USA
- Correspondence: ; Tel.: +1-717-531-0003
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Epigenetic Alterations in Sports-Related Injuries. Genes (Basel) 2022; 13:genes13081471. [PMID: 36011382 PMCID: PMC9408207 DOI: 10.3390/genes13081471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
It is a well-known fact that physical activity benefits people of all age groups. However, highly intensive training, maladaptation, improper equipment, and lack of sufficient rest lead to contusions and sports-related injuries. From the perspectives of sports professionals and those performing regular–amateur sports activities, it is important to maintain proper levels of training, without encountering frequent injuries. The bodily responses to physical stress and intensive physical activity are detected on many levels. Epigenetic modifications, including DNA methylation, histone protein methylation, acetylation, and miRNA expression occur in response to environmental changes and play fundamental roles in the regulation of cellular activities. In the current review, we summarise the available knowledge on epigenetic alterations present in tissues and organs (e.g., muscles, the brain, tendons, and bones) as a consequence of sports-related injuries. Epigenetic mechanism observations have the potential to become useful tools in sports medicine, as predictors of approaching pathophysiological alterations and injury biomarkers that have already taken place.
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