中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (10): 2166-2171.doi: 10.4103/1673-5374.335824

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

精确医学方法在创伤性脑损伤中的地位

  

  • 出版日期:2022-10-15 发布日期:2022-03-16

Status of precision medicine approaches to traumatic brain injury

Sahithi Reddi, Smita Thakker-Varia, Janet Alder, Anna O. Giarratana   

  1. Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
  • Online:2022-10-15 Published:2022-03-16
  • Contact: Anna O. Giarratana, PhD, anna.giarratana@rwjms.rutgers.edu.
  • Supported by:
    This work was supported by a grant from the New Jersey Commission on Brain Injury Research (No. CBIR16FEL009).

摘要: https://orcid.org/0000-0002-6734-7901 (Anna O. Giarratana)

Abstract: Traumatic brain injury (TBI) is a serious condition in which trauma to the head causes damage to the brain, leading to a disruption in brain function. This is a significant health issue worldwide, with around 69 million people suffering from TBI each year. Immediately following the trauma, damage occurs in the acute phase of injury that leads to the primary outcomes of the TBI. In the hours-to-days that follow, secondary damage can also occur, leading to chronic outcomes. TBIs can range in severity from mild to severe, and can be complicated by the fact that some individuals sustain multiple TBIs, a risk factor for worse long-term outcomes. Although our knowledge about the pathophysiology of TBI has increased in recent years, unfortunately this has not been translated into effective clinical therapies. The U.S. Food and Drug Administration has yet to approve any drugs for the treatment of TBI; current clinical treatment guidelines merely offer supportive care. Outcomes between individuals greatly vary, which makes the treatment for TBI so challenging. A blow of similar force can have only mild, primary outcomes in one individual and yet cause severe, chronic outcomes in another. One of the reasons that have been proposed for this differential response to TBI is the underlying genetic differences across the population. Due to this, many researchers have begun to investigate the possibility of using precision medicine techniques to address TBI treatment. In this review, we will discuss the research detailing the identification of genetic risk factors for worse outcomes after TBI, and the work investigating personalized treatments for these higher-risk individuals. We highlight the need for further research into the identification of higher-risk individuals and the development of personalized therapies for TBI.

Key words: apolipoprotein E, biomarkers, brain injury, brain-derived neurotrophic factor, clinical trials, personalized treatments, precision medicine, tau, translational research, traumatic brain injury