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Metabolomics Profiling As a Diagnostic Tool in Severe Traumatic Brain injury
Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland; Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma, Turku University Hospital, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland.
Turku Centre for Biotechnology, University of Turku, Turku, Finland.
Turku Centre for Biotechnology, University of Turku, Turku, Finland.ORCID iD: 0000-0002-2856-9165
Örebro University, School of Science and Technology. Department of Chemistry.
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2017 (English)In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 8, 398Article, review/survey (Refereed) Published
Abstract [en]

Traumatic brain injury (TBI) is a complex disease with a multifaceted pathophysiology. Impairment of energy metabolism is a key component of secondary insults. This phenomenon is a consequence of multiple potential mechanisms including diffusion hypoxia, mitochondrial failure, and increased energy needs due to systemic trauma responses, seizures, or spreading depolarization. The degree of disturbance in brain metabolism is affected by treatment interventions and reflected in clinical patient outcome. Hence, monitoring of these secondary events in peripheral blood will provide a window into the pathophysiological course of severe TBI. New methods for assessing perturbation of brain metabolism are needed in order to monitor on-going pathophysiological processes and thus facilitate targeted interventions and predict outcome. Circulating metabolites in peripheral blood may serve as sensitive markers of pathological processes in TBI. The levels of these small molecules in blood are less dependent on the integrity of the blood-brain barrier as compared to protein biomarkers. We have recently characterized a specific metabolic profile in serum that is associated with both initial severity and patient outcome of TBI. We found that two medium-chain fatty acids, octanoic and decanoic acids, as well as several sugar derivatives are significantly associated with the severity of TBI. The top ranking peripheral blood metabolites were also highly correlated with their levels in cerebral microdialyzates. Based on the metabolite profile upon admission, we have been able to develop a model that accurately predicts patient outcome. Moreover, metabolomics profiling improved the performance of the well-established clinical prognostication model. In this review, we discuss metabolomics profiling in patients with severe TBI. We present arguments in support of the need for further development and validation of circulating biomarkers of cerebral metabolism and for their use in assessing patients with severe TBI.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2017. Vol. 8, 398
Keyword [en]
traumatic brain injury, metabolomics, biomarker, neuromonitoring, outcome, mass spectrometry
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-60721DOI: 10.3389/fneur.2017.00398ISI: 000408315900001Scopus ID: 2-s2.0-85027569514OAI: oai:DiVA.org:oru-60721DiVA: diva2:1140176
Note

Funding Agencies:

EVO  

Emil Aaltonen Foundation 

Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2017-11-29Bibliographically approved

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Orešič, MatejHyötyläinen, Tuulia

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