Abstract
The biological consequences of exposure to explosive blast are extremely complex. Serum protein biomarkers in blast-induced traumatic brain injury (bTBI) can aid in determining injury severity, monitoring progress, and predicting outcome. Exposure to blast results in varying degrees of physical injury. Explosive blast can also induce psychological stress that can contribute to or amplify the extent of physical damage. Given the complexity, scale of injury, and variety of symptoms, bTBI may be best described as a spectrum disorder. In this focused review, we summarize the status of serum protein biomarkers in bTBI in the context of the classification and pathological changes of other forms of TBI. Finally, we recommend specific and easily implementable measures to accelerate serum protein biomarker discovery and validation in bTBI.
Highlights
SUMMARY AND FUTURE DIRECTIONS We would like to conclude this focused review by suggesting three relatively easy and implementable measures that can speed up both serum protein biomarker discovery and validation in bTBI
First: blood should be obtained at multiple time points in both experimental and clinical studies in order to enable the longitudinal analysis of changes in serum levels of protein markers in bTBI
Third: changes in serum protein biomarkers should be analyzed in relation to functional and neurobehavioral changes in both clinical and experimental settings
Summary
Serum biomarkers in blast TBI incidence rates of TBI have been increasing since 2000 (Sayer, 2012). CLASSIFICATION OF BLAST-INDUCED TRAUMATIC BRAIN INJURY Individuals who experience less than 30 minutes of lost or altered levels of consciousness after exposure to blast are classified as having suffered mild bTBI (mibTBI; Figure 1; Trudeau et al, 1998; Hoge et al, 2008; Elder et al, 2010; Levin et al, 2010; Rosenfeld and Ford, 2010; Wilk et al, 2010) This initial period may be followed by post-injury amnesia that lasts no longer than 24 hours. NSE GFAP MBP pNF -H NF -H Hsp Secretagogin IL -1β IL -6 IL -8 TNF -α UCH -L1 C -tau
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