Dr. Lifshitz and his team

UArizona-TGen Led Team Identifies New Biomarkers to Diagnose and Monitor Brain Injuries

Dr. Lifshitz and his team
Integrated Protein and Metabolite Analysis Opens the Door to More Precise Ways of Guiding Treatment for the Nearly 70 million People Worldwide Who Annually Suffer Traumatic Brain Injuries

A scientific team led by the University of Arizona and the Translational Genomics Research Institute (TGen), an affiliate of City of Hope, identified a robust set of biomarkers through proteomics and metabolomic analysis that could help guide treatment for tens of millions of patients who each year sustain brain injuries, potentially preventing severe long-term disabilities.

The team’s findings were reported in a study published in the Nature journal: Scientific Reports.

An estimated 69 million people worldwide annually sustain traumatic brain injury (TBI). That includes at least 3 million in the U.S. — resulting in nearly 288,000 hospitalizations, 56,800 deaths and more than 90,000 with permanent disabilities.

One of the practical applications of the study was to show the effectiveness of a treatment for brain injuries known as Remote Ischemic Conditioning (RIC). RIC involves, for example, using a tourniquet to restrict, then release, the flow of blood in one of the head-injury patient’s arms or legs. Scientists still don’t know why, but circulating molecules in the bloodstream are produced that could help the brain minimize or repair the injury through this seemingly unrelated technique of on-again, off-again flow of oxygen and nutrients to a patient’s limb.

“The molecules released by alternately restricting and releasing the blood flow seem to have a neuro-protective effect,” said Patrick Pirrotte, PhD, director of TGen’s Collaborative Center for Translational Mass Spectrometry and one of the study’s senior authors.

Using mice models and TGen’s state-of-the-art mass spectrometry facility to analyze proteins and metabolites, Dr. Pirrotte’s team identified biomarkers that showed the effectiveness of RIC, and additional biomarkers that could be used to measure the presence of the injury.

Premature return to normal or strenuous activities can worsen the (TBI) condition and induce chronic health-related issues, the study says, further exacerbating the onset of neurodegenerative diseases.

“The biomarkers we identified allow us to measure the extent of the injury, and monitor RIC-aided recovery from brain injury,” said Khyati Pathak, PhD, a member of Dr. Pirrotte’s team and one of the study’s authors.

The newly-identified biomarkers can provide a more exacting, molecular-level diagnosis of TBI.

“Traumatic brain injury, particularly in its less severe form, may not seemingly require hospitalization or an emergency room visit,” said Jonathan Lifshitz, PhD, director of the UArizona’s Translational Neurotrauma Research Program: a joint venture between the UArizona College of Medicine – Phoenix; a branch of Barrow Neurological Institute at Phoenix Children’s Hospital; and the Phoenix VA Health Care System.

“For millions of individuals, there often is no health care access immediately after TBI events, whether it be organized sports, recreational activities, occupational hazards, military service or domestic violence,” said Dr. Lifshitz, one of the study’s senior authors.

The use of RIC — the alternating restriction and release of blood flow to an arm or leg — has been shown in clinical studies to be effective in other emergency medical situations, including cardiac arrest, organ transplantation and lung injury.

“RIC is an easy to teach, practical intervention for a brain injury outside of the hospital setting. It allows for immediate care to the patient with the intent to reduce brain injury pathology,” said Maha Saber, PhD, who is affiliated with Barrow and UArizona and is the study’s lead author.

This research study — Proteomic analysis identifies plasma correlates of remote ischemic conditioning in the context of experimental traumatic brain injury — was funded by grants from the National Institutes of Health (NIH-R21-NS096515, F31-NS090921, and T32-AG044402).

Story by: Steve Yozwiak, a senior science writer at TGen.

This story originally appeared on TGen’s website.

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Founded in 2007, the University of Arizona College of Medicine – Phoenix inspires and trains exemplary physicians, scientists and leaders to optimize health and health care in Arizona and beyond. By cultivating collaborative research locally and globally, the college accelerates discovery in a number of critical areas — including cancer, stroke, traumatic brain injury and cardiovascular disease. Championed as a student-centric campus, the college has graduated 593 physicians, all of whom received exceptional training from nine clinical partners and more than 2,400 diverse faculty members. As the anchor to the Phoenix Biomedical Campus, which is projected to have an economic impact of $3.1 billion by 2025, the college prides itself on engaging with the community, fostering education, inclusion, access and advocacy.