A Framework to Advance Biomarker Development in the Diagnosis, Outcome Prediction, and Treatment of Traumatic Brain Injury.
A Framework to Advance Biomarker Development in the Diagnosis, Outcome Prediction, and Treatment of Traumatic Brain Injury.
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DOI：
10.1089/neu.2021.0099
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发表时间：
2022-04
影响因子：
4.2
通讯作者：
Jeromin A
中科院分区：
文献类型：
--
作者：
Wilde EA;Wanner IB;Kenney K;Gill J;Stone JR;Disner S;Schnakers C;Meyer R;Prager EM;Haas M;Jeromin A
独特的创伤性脑损伤(TBI)内表型的多模式生物标志物(如成像、基于血液的、生理学的)对于指导个性化和靶向治疗的发展是必要的。最佳的生物标志物将是特定的、敏感的、快速和容易获得的、最小的侵入性、成本效益和临床和研究用途的双向可翻译的。对于这两种用途，了解TBI生物标志物如何随着时间的推移而变化，对于可靠地确定随着损伤的发展而进行干预的适当时间窗口至关重要。精确的医疗保健需要生物标记物，使研究人员和临床医生能够识别细胞损伤并监测患者临床轨迹的临床改善、转折、停滞或恶化。可靠地预测结果和恢复窗口以评估神经退行性变化并指导重返比赛或职责的决定的预后生物标志物也很重要。满足这些需求的TBI生物标记物将改变临床实践，并可能降低患者出现长期症状和持久缺陷的风险。本文概述了目前正在研究的生物标记物，并概述了实现短期和长期目标的必要步骤，包括生物标记物如何促进脑外伤的治疗和改善对脑外伤患者的护理。
Multi-modal biomarkers (e.g., imaging, blood-based, physiological) of unique traumatic brain injury (TBI) endophenotypes are necessary to guide the development of personalized and targeted therapies for TBI. Optimal biomarkers will be specific, sensitive, rapidly and easily accessed, minimally invasive, cost effective, and bidirectionally translatable for clinical and research use. For both uses, understanding how TBI biomarkers change over time is critical to reliably identify appropriate time windows for an intervention as the injury evolves. Biomarkers that enable researchers and clinicians to identify cellular injury and monitor clinical improvement, inflection, arrest, or deterioration in a patient's clinical trajectory are needed for precision healthcare. Prognostic biomarkers that reliably predict outcomes and recovery windows to assess neurodegenerative change and guide decisions for return to play or duty are also important. TBI biomarkers that fill these needs will transform clinical practice and could reduce the patient's risk for long-term symptoms and lasting deficits. This article summarizes biomarkers currently under investigation and outlines necessary steps to achieve short- and long-term goals, including how biomarkers can advance TBI treatment and improve care for patients with TBI.
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