Impact of Aging on the Immune Response to Traumatic Brain Injury

描述(申请人提供)：创伤性脑损伤(TBI)在老年人中很常见，每年占美国脑损伤的25%以上，具有相当大的死亡率、长期损伤和残疾。与患有类似损伤的年轻人相比，患有脑外伤的老年人的结果要差得多。临床上治疗老年人脑外伤的努力并没有在身体损伤、残疾和与健康相关的生活质量方面产生预期的改善。管理的关键障碍 颅脑损伤的原因在于，人们对衰老导致的脑外伤反应的潜在差异以及老年如何影响脑外伤后的病理和康复知之甚少。目前的应用建议使用一组新的免疫生物标记物来加强对脑外伤后康复轨迹的了解，以及导致脑外伤后老年人健康相关生活质量的慢性症状、损害和下降的潜在机制。我们认为，衰老是一个生物学因素，通过调节对脑外伤的免疫反应来促进对损伤的病理反应，并将使用一个新的损伤和残疾模型来验证这一假设。这项前瞻性队列研究的目的是：1)比较患有和不患有轻度脑外伤的年轻人和老年人在受伤后6个月内的细胞免疫反应、血浆炎症生物标记物浓度以及损害、残疾和健康相关生活质量的测量(每组75人)，以及2)确定选定的细胞免疫和血浆生物标志物与损伤、残疾和健康相关生活质量之间的关系。

DESCRIPTION (provided by applicant): Traumatic brain injury (TBI) in older adults is common, accounting for over 25% of brain injuries in the US each year, with considerable mortality, long-term impairment and disability. Outcomes among older adults with TBI are disparately worse when compared to their younger counterparts with similar injuries. Clinical efforts to treat TBI in older adults have not yielded the expected improvements in physical impairment, disability and health- related quality of life. A critical barrier to the management of TBI is that there is limited knowledge about potential differences in the response to TBI that results from aging, and how older age may affect pathology and recovery following TBI. The current application proposes to use a novel set of immune biomarkers to enhance knowledge of the trajectory of recovery from TBI and the underlying mechanisms responsible for chronic symptoms, impairment and decrements in health-related quality of life in older adults following TBI. We propose that aging is a biological factor that contributes to the pathological response to injury by modulating the immune response to TBI and will test this hypothesis using a novel model of impairment and disability. The aims of this prospective cohort study are to: 1) Compare cellular immune responses, plasma inflammatory biomarker concentrations, and measures of impairments, disability and health-related quality of life up to 6 months post-injury in young and older adults with and without mild TBI (75 per group) and 2) Determine the association between selected cellular immune and plasma biomarkers and impairments, disability and health- related quality of life at 3 and 6 months post-injury in older adults with mild TBI.